title: [Montgomery salivary bypass tube: a simple solution for pharyngocutaneous fistulas].
abstract: BACKGROUND
  The pharyngocutaneous fistulas (PCF) are among the complications surgeons and nursing personnel fear the most due to their complexity to prevent and/or cure them. Montgomery salivary bypass tube is an effective therapeutic option in the treatment of the PCF following laryngectomy. The aim of our study was to describe our experience with salivary bypass in the treatment of the PCF.
  
  
  METHODS
  This was a retrospective analysis of pharyngocutaneous fistulas in 21 patients in whom total laryngectomy was performed for squamous cell carcinoma of the larynx or hypopharynx (January 1999-December 2005). We determinate the overall efficacy of the Montgomery salivary bypass tube in the treatment of the PCF.
  
  
  RESULTS
  A pharyngocutaneous fistula developed within a mean time of 7 days from surgery (from 2nd to 20th day). Montgomery salivary bypass tube was the therapeutic option in all these PCF.12 patients required local anesthesia to introduce the tube and in 9 patients the insertion method was with general anesthesia with direct vision of the hypopharynx. The mean healing time was 26 days, except in one case. This PCF achieved spontaneous closure with local wound care after the bypass was removed.
  
  
  CONCLUSIONS
  The observed results corroborated the relevance of Montgomery salivary bypass tube as an important therapeutic option in the treatment of the PCF. There was no need of surgical treatment.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias. maritina79@hotmail.com
authors.forename: M A
authors.initials: MA
authors.lastname: Sevilla García
authors.forename: V
authors.initials: V
authors.lastname: Suárez Fente
authors.forename: J P
authors.initials: JP
authors.lastname: Rodrigo Tapia
authors.forename: J L
authors.initials: JL
authors.lastname: Llorente Pendás
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002404:Catheterization / Q000379:methods*; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012469:Salivary Glands / Q000601:surgery*; D012472:Salivation / Q000502:physiology*