Pharyngocutaneous Fistula as a Complication of Total Laryngectomy: Review of the Literature and Analysis of Case Records

Cavalot, A; Gervasio, Carmine-Fernando; Nazionale, G; Albera, Roberto; Bussi, Mario; Staffieri, Alberto; Ferrero, Vittorio; Cortesina, G

doi:10.1067/mhn.2000.110617

Cited by 164 publications

(163 citation statements)

References 18 publications

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“…Dans notre série, la trachéotomie première et l'infection pariétale ont constitué les principaux facteurs ayant favorisé la survenue de pharyngostome. Les complications tardives sont représentées essentiellement par la sténose du trachéostome, la sténose pharyngo-oesophagienne et l'hypothyroïdie (3,4,8). Dans notre série, ces complications étaient rares.…”

Section: Discussionunclassified

Laryngectomie totale résultats de l’expérience du service d’orl de sfax

Charfeddine¹,

Hammami²,

Bouayed³

et al. 2010

Journal Tunisien d'ORL Et De Chirurgie Cervico-Faciale

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Le cancer du larynx est un cancer fréquent. Son traitement est, dans notre pays, essentiellement chirurgical. Les différentes chirurgies réalisées dépendent du stade tumoral et du statut ganglionnaire. La laryngectomie totale (LT) reste l'intervention la plus fréquemment réalisée dans notre pays.Le but de notre travail est d'évaluer les résultats opéra-toires et évolutifs de la laryngectomie totale sur une série de 187 patients. (1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005). La tumeur a été classée T3T4 dans 87,8 % des cas. L'atteinte des 3 étages était trouvée dans 56% des cas et l'extension extra laryngée dans 59 % des cas. Une trachéotomie première pour dyspnée laryngée a été réalisée dans 44 % des cas. La laryngectomie était étendue au pharynx ou à la base de la langue dans 43 % des cas. Résultats : Les suites opératoires ont été marquées par l'apparition d'un pharyngostome chez 19% des patients et par une infection dans 11% des cas. Les limites de résection ont été tumorales dans 14% des cas. Une radiothérapie postopératoire a été réalisée dans 92,5% des cas. Une rééducation orthophonique a pu être réalisée chez 36% des patients. Sur un recul moyen de 40 mois (2 à 132 mois), une récidive tumorale ou ganglionnaire a été retrouvée dans 8 % et 5 % des cas respectivement. Le taux de métastase à distance était de 11 % des cas. Une deuxième localisation a été objectivée dans 4 % des cas. La survie moyenne à 5 ans était de 75 %. Discussion : La laryngectomie totale est une intervention mutilante, par le handicap vocal qu'elle engendre mais la survie à 5 ans est de 75%. La perte définitive de la fonction phonatoire du larynx en constitue l'handicap majeur. Le diagnostic plus précoce de ces cancers dans notre pays peut permettre d'autres alternatives thérapeutiques. Mots-clés : Laryngectomie totale, pharyngostome, cancers laryngés. PATIENTS ET METHODES SUMMARY Introduction :Total laryngectomy (TL) is still mostly realized in our country for laryngeal cancer. The aim of our study is to estimate the postoperative and evolutionary results of patients who have TL. Patients and methods : It's a retrospective study about 187 cases of laryngeal cancer treated by total laryngectomy, in ENT department during 19 years (1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005). The tumor was classified T3T4 in 87% of the cases. A tracheotomy before TL was realized in 44 % of the cases. Laryngectomy was extended to the pharynx or basis tongue in 43%. Results : Post operative complications were represented essentially by pharyngostoma in 18% and infection in 11%. Resection limits were invaded in 14% of the cases. Postoperative radiotherapy was performed in 92%. Orthophonic rehabilitation was practice for only 36% of patients. During 40 months mean follow-up (2 to 132 months), the tumor or the lymph nodes recurrence was respectively founded in 8% and 4% of the cases. Distance metastasis rate was 11% of the...

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Section: Discussionunclassified

Laryngectomie totale résultats de l’expérience du service d’orl de sfax

Charfeddine¹,

Hammami²,

Bouayed³

et al. 2010

Journal Tunisien d'ORL Et De Chirurgie Cervico-Faciale

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“…Preservation of larynx means larynx in place, no residual tumor, and also no tracheotomy and no feeding tube. Preservation of function is more important than just anatomic integrity of the larynx [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

Stanković¹,

Milisavljević²,

Stankovic³

2017

J Nucl Med Radiat Ther

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Purpose: To compare the complications and survival rate after different treatment modalities of advanced laryngopharyngeal cancer. Methods:Retrospective study included 619 advanced laryngopharyngeal carcinoma, treated with either primary total laryngectomy (PTL), or salvage (STL) after partial laryngectomy, radio, chemoradiotherapy. Complications and survival rate were documented.Results: Five years disease free survival rate amounted 60.9% for PTL, 54.3% for STL after partial laryngectomy, 50% for STL after radiotherapy and 43.8% for STL after chemoradiotherapy. Histologically positive neck was highly significantly associated with worse prognosis, much more than recurrence within larynx. Conclusion:PTL gives the best survival rate with low complications for advanced laryngopharyngeal squamous cell carcinoma. Complications and survival rate of STL significantly depend on previous treatment of laryngopharyngeal cancer.

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“…PCF leads to significantly increased morbidity, duration of hospitalization, and financial burden, in addition to delaying the start of indicated adjuvant therapy [1] like radiotherapy and chemotherapy. Salivary fistulae also cause considerable discomfort as patients have to be fed through nasogastric tubes [2].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Double Layered Repair of Pharyngeal Mucosa Against Routine Single Layered Repair in Cases of “Total Laryngectomy with Partial Pharyngectomy” in Respect To Formation of Pharyngo-cutaneous Fistula

Shukla

Dudeja

2014

Indian J Otolaryngol Head Neck Surg

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Advanced glottic cancer (T3,N? & T4) is usually treated in the majority of centres by total laryngectomy. Carcinoma of the larynx is one of the very few subsets of all cancers which have shown a decrease in the 5 year survival rate and this phenomenon has been attributed to a Pharyngocutaneous fistula is the most common complication after total laryngectomy. Comparative study between double layered repair of pharyngeal mucosa against routine single layered repair in cases of ''total laryngectomy with partial pharyngectomy''. All patients with the principal procedure of ''total laryngectomy with partial pharyngectomy'' in department of otorhinolaryngology and head-neck surgery, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India were included in this study. Out of the 20 patients who had undergone total laryngectomy irrespective of the type of mucosal repair, 5 (25 %) patients developed pharyngocutaneous fistula. Out of the 8 patients, with double layered mucosa repair, 1 (12.5 %) patient developed pharyngocutaneous fistula. Out of the 12 patients, with single layered mucosa repair, 4 (33 %) patients developed pharyngocutaneous fistula. Double layered repair of pharyngeal mucosa is associated with a lower incidence of pharyngocutaneous fistula formation and no increased incidence of dysphagia after complete radiotherapy as compared to single layered repair.

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Pharyngocutaneous Fistula as a Complication of Total Laryngectomy: Review of the Literature and Analysis of Case Records

Cited by 164 publications

References 18 publications

Laryngectomie totale résultats de l’expérience du service d’orl de sfax

Laryngectomie totale résultats de l’expérience du service d’orl de sfax

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

Comparative Study Between Double Layered Repair of Pharyngeal Mucosa Against Routine Single Layered Repair in Cases of “Total Laryngectomy with Partial Pharyngectomy” in Respect To Formation of Pharyngo-cutaneous Fistula

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