Causes and consequences of anterior pharyngeal pouch after total laryngectomy.
OBJECTIVE
To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation.


METHODS
A prospective, observational study of 43 patients undergoing total laryngectomy.


METHODS
Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation.


RESULTS
The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation.


CONCLUSIONS
The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.
Institute of Surgery,Townsville Hospital,Australia.
S
S
Anderson
ENT Department,Mater Hospital,Brisbane,Australia.
D
D
Hogan
Department of Otolaryngology, Head and Neck Surgery,Princess Alexandra Hospital,Brisbane, Queensland,Australia.
B
B
Panizza
D001466:Barium Sulfate; D005402:Fistula / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D058106:Wound Closure Techniques / Q000009:adverse effects*
D001466:Barium Sulfate