title: Effects of salivary bypass tubes on fistula and stricture formation.
abstract: OBJECTIVE
  Stricture and fistula formation are two of the most common long-term complications of free flap reconstruction of hypopharyngeal defects.
  
  
  OBJECTIVE
  To examine the effects of salivary bypass tubes (SBTs) on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Academic tertiary care medical center.
  
  
  METHODS
  A total of 103 consecutive patients who underwent hypopharyngeal free flap reconstruction.
  
  
  METHODS
  Use of salivary bypass tube.
  
  
  METHODS
  Fistula and stricture formation.
  
  
  RESULTS
  The overall fistula and stricture rates were 14.6% and 27.2%, respectively. Subgroup analysis revealed fistula rates of 7.4% in patients who received SBTs and 22.4% in those who did not (P = .048). However, no statistically significant difference between the two groups was shown with multivariate analysis. The unadjusted stricture rate was 30.6% without vs 24.1% with SBT placement (P = .51).
  
  
  CONCLUSIONS
  Univariate analysis showed that SBT placement significantly reduced the risk of fistula in this population. Larger multicenter studies are needed to further explore the benefits of SBT use in preventing fistula and stricture formation.
  
  
  METHODS
  3.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Xerxes
authors.initials: X
authors.lastname: Punthakee
authors.forename: Soroush
authors.initials: S
authors.lastname: Zaghi
authors.forename: Vishad
authors.initials: V
authors.lastname: Nabili
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Knott
authors.forename: Keith E
authors.initials: KE
authors.lastname: Blackwell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D004947:Esophagus / Q000601:surgery; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery*; D015994:Incidence; D007440:Intubation / Q000295:instrumentation / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010608:Pharyngeal Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016156:Respiratory Tract Fistula / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012463:Saliva; D015607:Stents; D016896:Treatment Outcome