title: Pharyngocutaneous fistula following total laryngectomy: a single institution's 10-year experience.
abstract: The etiology of postoperative pharyngocutaneous fistula (PCF) formation following major head and neck surgery is multifactorial and the incidence varies greatly. We reviewed retrospectively the records of 108 consecutive patients who underwent a total laryngectomy during the period from December 1992 to December 2002 at the Helsinki University Central Hospital, Helsinki, Finland. PCF occurred postoperatively in 19 (18%) patients. Two additional patients (2%) developed a PCF later than 30 days after laryngectomy. Nineteen percent of these patients with fistula formation had received previous radiation therapy and laryngectomy was performed for local recurrence. Eighteen (86%) of the all fistulae closed spontaneously and surgical closure of the fistula was performed in three (14%) cases. We conclude that the PCFs in our patient population occurred both in radiated and nonirradiated patients. Although most fistulae close spontaneously without surgical intervention this complication leads to prolonged hospitalization and increased patient morbidity.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Helsinki University Central Hospital, P.O. Box 220, 00029 HUCH, Helsinki, Finland. antti.makitie@hus.fi
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Riina
authors.initials: R
authors.lastname: Niemensivu
authors.forename: Mari
authors.initials: M
authors.lastname: Hero
authors.forename: Harri
authors.initials: H
authors.lastname: Keski-Säntti
authors.forename: Leif
authors.initials: L
authors.lastname: Bäck
authors.forename: Mikael
authors.initials: M
authors.lastname: Kajanti
authors.forename: Hannu
authors.initials: H
authors.lastname: Lehtonen
authors.forename: Timo
authors.initials: T
authors.lastname: Atula
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017577:Cutaneous Fistula / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D003710:Demography; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors