title: Partial laryngectomies: when the problem is the pexy.
abstract: To analyse the complications related to pexy, the main clinical manifestations that may raise suspicions of a pexy line rupture/detachment, the most suitable diagnostic technique and the optimum treatment to resolve this complication. This is a retrospective chart review in tertiary university referral centre. Medical charts of patients with oncological laryngeal pathologies admitted to the Otolaryngology Department of the University Hospital of Modena between May 2003 and March 2012 were analysed. Ten patients with rupture of the pexy were identified and included in the present study. The clinical manifestations were dysphagia, alteration of sensitivity of hypopharyngeallaryngeal structures, fever, infection and diastasis of surgical wounds, bleeding, dysphonia and aspiration pneumonia. Rupture of the pexy was diagnosed through endoscopic evaluations, radiological techniques or directly in the operating room during revision surgery of the earlier operation. Surgical treatments, coupled with effective swallowing rehabilitation, allowed progressive functional recovery. Patients were hospitalised until recovery of laryngeal functions was complete. In conclusion, pexy line rupture is one of the complications in the post-operative period of partial laryngectomies. Certain clinical manifestations may indicate this complication, helping the surgeon to establish an early diagnosis and administer prompt treatment.
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Ruberto
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
authors.forename: M
authors.initials: M
authors.lastname: Alicandri-Ciufelli
authors.affiliation: Otolaryngology Department, National Institute of Cancer "Regina Elena" IRCCS, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Grammatica
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
authors.forename: D
authors.initials: D
authors.lastname: Marchioni
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
authors.forename: G
authors.initials: G
authors.lastname: Bergamini
authors.affiliation: Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
authors.forename: L
authors.initials: L
authors.lastname: Presutti
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Dysphagia; Dyspnoea; Laryngeal cancer; Partial laryngectomies; Pexy