title: Effectiveness of Recombinant Human Growth Hormone for Pharyngocutaneous Fistula Closure.
abstract: OBJECTIVE
  In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase in amino acid uptake and protein synthesis for wound healing, an increase in mitogenesis, and enhancement of collagen formation by recombinant human growth hormone.
  
  
  METHODS
  This study was experimental animal study. Forty Sprague-Dawley rats were separated into two groups, and pharyngoesophagotomy was performed. The pharyngoesophagotomy was sutured with vicryl in both groups. Rats in group 1 (control group) received no treatment, while those in group 2 were administered a subcutaneous injection of recombinant human growth hormone daily. On day 14, the pharynx, larynx, and upper oesophagus were excised and examined microscopically.
  
  
  RESULTS
  Pharyngocutaneous fistula exhibited better closure macroscopically in the recombinant human growth hormone group. There was a significant difference in collagen formation and epithelisation in the recombinant human growth hormone group compared to the control group.
  
  
  CONCLUSIONS
  This study is believed to be the first in which the effect of recombinant human growth hormone on pharyngocutaneous fistula closure was evaluated, and the findings suggest the potential of use of growth hormone for treatment of pharyngocutaneous fistula.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Kucuk
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sari
authors.affiliation: Department of Pathology, Bahcesehir University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Midi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Ali Cemal
authors.initials: AC
authors.lastname: Yumusakhuylu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Findik
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Binnetoglu
keywords: Pharyngocutaneous Fistula; Postoperative Laryngectomy Complications; Recombinant Human Growth Hormone