Prevention of postlaryngectomy pharyngocutaneous fistula using a sternocleidomastoid muscle collar flap.
OBJECTIVE
The purpose of this study was to evaluate the efficacy of a sternocleidomastoid muscle collar flap in the prevention of pharyngocutaneous fistula in patients who had undergone total laryngectomy.


METHODS
Retrospective clinical study.


METHODS
Otolaryngology department, Tanta University, Egypt.


METHODS
Sixty-five consecutive total laryngectomy procedures performed between October 1999 and October 2005 were reviewed. The fistula rate in laryngectomy patients operated on prior to 2002, without sternocleidomastoid collar flap creation (group A) was compared with that of patients operated on after October 2002, at which time this flap was introduced for routine use during primary surgery (group B).


RESULTS
In group A, the incidence of pharyngocutaneous fistula was 12 in 35 (34 per cent) while its incidence in group B was 1 in 30 (3.3 per cent). On analysis, the risk factors within both the groups were essentially similar.


CONCLUSIONS
The routine addition of a superiorly based sternal head of sternocleidomastoid muscle flap on one or both sides to cover the repaired pharynx during surgery reduced the incidence of postlaryngectomy pharyngocutaneous fistula, patient morbidity and mortality, and hospital stay; voice rehabilitation and swallowing were also improved.
Albirmawy
O A
OA
Otolaryngology Department, Tanta University, Tanta, Egypt. Albirmawy@hotmail.com
D000328:Adult; D000368:Aged; D017577:Cutaneous Fistula / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005402:Fistula / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013071:Speech, Alaryngeal; D013524:Surgical Flaps; D016896:Treatment Outcome