Long-term oral intake through a salivary bypass tube with chronic pharyngocutaneous fistula.
Pharyngocutaneous fistulae (PCFs) are a common complication after total laryngectomy. Patients with persistent PCFs are often kept nil by mouth and are dependent on feedings via a gastric tube. Our patient is a 65-year-old man who presented to our clinic in 2008 having a persistent PCF after a total laryngectomy who failed numerous attempts at reconstruction. We inserted a salivary bypass tube as a method of spanning the PCF and advanced his oral diet. He has been able to tolerate a regular diet 30 months postoperatively with no dysphagia and has gained weight. This is a demonstration of salivary bypass tubes as a useful adjunct to maintain oral intake in the presence of a persistent PCF.
Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, MD, USA. zgooi1@jhmi.edu
Zhen
Z
Gooi
Jeremy
J
Richmon
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D017577:Cutaneous Fistula / Q000209:etiology* / Q000534:rehabilitation; D004750:Enteral Nutrition / Q000379:methods*; D005402:Fistula / Q000209:etiology / Q000534:rehabilitation; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D010608:Pharyngeal Diseases / Q000209:etiology* / Q000534:rehabilitation; D011183:Postoperative Complications; D012469:Salivary Glands / Q000601:surgery*; D012472:Salivation; D013997:Time Factors