Intraoperative dye test in total laryngectomy: A technique to reduce the incidence of pharyngocutaneous fistula

Background Pharyngocutaneous fistula (PCF) is considered the most common suffering complication in laryngectomized patients. PCF occurs variably from 10 to 20% and sometimes reaches more than 60%, as a result of a combination of local and systemic factors related to poor tissue healing and wound breakdown. Development of PCF affects the restoration of normal life after laryngectomy that could potentially lead to major complications affecting patient survival. Aim of study We studied the role of blue dye test in the early detection of PCF post-laryngectomy, which could potentially lead to optimum management which can reduce the duration of hospital stay as well as major complications out of salivary leakage. Results Out of 64 patients who underwent TL from Jan 2020 till Dec 2021 at a Tertiary Head and Neck Cancer Center, 40 patients were included in the study. All these patients underwent blue dye test and barium swallow considered the standard postoperative leak test. Patients’ characteristics as well as associated comorbidities have been studied as well as blue dye test findings compared to barium swallow, including median time for diagnosis of PCF, duration, management plan, additional leak tests, and length of hospital stay. Conclusion Blue dye test gives a good clue for early detection with proper management of PCF, which could eventually result in early recovery and reduce cost, morbidity, and hospital stay. It can be repeatedly performed to establish a simple, reliable, and safe bedside tool for follow-up.

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Role of blue dye test as an early predictor of post-laryngectomy pharyngocutaneous fistula

Alsedra

Zahran

Taha

et al. 2023

Egypt J Otolaryngol

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Persistent Neopharynx Pseudomonas Infection After a Sealed Anastomotic Leak Post Total Laryngectomy

Baki¹,

Ridzam²,

Rahim³

2022

Cureus

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Total laryngectomy (TL) is the treatment of choice for advanced glottic cancer. Post-operative complications can be debilitating for patients, family members and healthcare workers. Complications following TL have been reported in many studies, with pharyngocutaneous fistula and wound infection being the most common. Identifying the risk factors that may give rise to these complications is vital to minimise postoperative morbidity. We present the case of a 62-year-old male who underwent salvage TL following radiation therapy for recurrent glottic carcinoma. The patient developed diffuse submental swelling upon the commencement of oral feeding. A flexible nasopharyngolaryngoscopy revealed a sloughy area at the neopharynx, with the finding of a sealed anastomotic leak on a repeat barium swallow study. We report persistent Pseudomonas aeruginosa infection following salvage TL, after a sealed anastomotic leak.

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Intraoperative dye test in total laryngectomy: A technique to reduce the incidence of pharyngocutaneous fistula

Cited by 2 publications

References 11 publications

Role of blue dye test as an early predictor of post-laryngectomy pharyngocutaneous fistula

Role of blue dye test as an early predictor of post-laryngectomy pharyngocutaneous fistula

Persistent Neopharynx Pseudomonas Infection After a Sealed Anastomotic Leak Post Total Laryngectomy

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