Spontaneous pharyngeal fistula and wound infection following laryngectomy

Briant, T. D. R.

doi:10.1288/00005537-197505000-00007

Cited by 65 publications

(42 citation statements)

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“…Preoperative radiation is the single most important cause of fistula formation (1,2). In the present series, six cases had received radiation over 50 Gy and the remaining nine cases had no irradiation.…”

Section: Discussionmentioning

confidence: 72%

Closure of Large Pharyngo-Oesophageal Fistulas With Free Flap Transfer After Resections for Cancer

Nakatsuka

Harii

Ebihara³

et al. 1998

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Postoperative salivary fistulas still remain a serious and potentially lethal problem in head and neck reconstruction particularly if the fistula is large and involving one half or more of the circumference of the pharyngo-oesophagus. Pedicled flaps have traditionally been the flaps of choice for closure of these fistulas, but the results are often disappointing. During the period 1982 to 1995, we have used either a radial forearm free flap or a jejunal free flap to close large and complex pharyngo-oesophageal fistulas after resection for cancer in 15 patients. Although two patients developed major fistulas that required additional operations for closure, successful closure was achieved in all but one case: the success rate was therefore 14/15 (93%). We consider that jejunal flaps are suitable for circumferential pharyngo-oesophageal reconstruction and forearm flaps for non-circumferential defects.

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Section: Discussionmentioning

confidence: 72%

Closure of Large Pharyngo-Oesophageal Fistulas With Free Flap Transfer After Resections for Cancer

Nakatsuka

Harii

Ebihara³

et al. 1998

Scandinavian Journal of Plastic and Reconstructive Surgery and

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“…Spontaneous closure is expected in most patients who have a small anterior or laterally positioned type III fistula when the greater portion of the neck is healed. 13 However, larger type III orocutaneous fistulas in this region (submandibular or submental) must also be addressed with tissuetransfer techniques for definitive treatment. Six of the 26 patients in whom a type III fistula developed were treated with local-flap procedures on an outpatient basis.…”

Section: Resultsmentioning

confidence: 99%

Critical Oropharyngocutaneous Fistulas after Microsurgical Head and Neck Reconstruction: Indications for Management Using the ???Tissue-Plug??? Technique

Salgado

Mardini

Chen

et al. 2003

Plastic and Reconstructive Surgery

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Despite advances in head and neck reconstruction with free-tissue transfer techniques, oropharyngocutaneous fistulas continue to present challenging and potentially lethal complications. The authors present a system for prioritizing these fistulas and the surgical management of nine patients in whom critical fistulas developed after microsurgical head and neck reconstruction. The indications for aggressive management of these fistulas were primarily dependent on their location. Three peristomal and six midneck fistulas were considered critical because of the risk of aspiration pneumonia and carotid artery blowout, respectively. Fistulas located in the submental and/or submandibular region were considered noncritical and were managed conservatively. Using the concept of a "tissue plug" for fistula repair, a dermal component (i.e., a deltopectoral or pectoralis major pedicled flap) is guided through the fistula, and with external traction the tissue "plugs" the tract. No sutures are placed directly in the surrounding friable tissue. There were no partial or total flap losses. There were two fistula recurrences in patients who had received postoperative radiation therapy. One of these recurrences was due to tumor recurrence within the previous fistula and was managed with palliative measures. The other fistula recurrence was closed with a local-flap procedure on an outpatient basis. All patients resumed oral feeding, except for the patient in whom tumor recurrence was suspected. This tissue-plug technique can be used in the management of critical peristomal and/or midneck oropharyngocutaneous fistulas not only to obliterate the tract but also to augment volume and vascularity in already damaged, ischemic, and deficient tissue.

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“…Fistulation rates range from 4% to 44% (13)(14)(15) . This was the most common early complication in our study (five patients; 12.5%).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of laryngeal cancer cases treated at our clinic from 2000 to 2005

Dinç¹

2018

Okmeydani Medical Journal

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Spontaneous pharyngeal fistula and wound infection following laryngectomy

Cited by 65 publications

References 0 publications

Closure of Large Pharyngo-Oesophageal Fistulas With Free Flap Transfer After Resections for Cancer

Closure of Large Pharyngo-Oesophageal Fistulas With Free Flap Transfer After Resections for Cancer

Critical Oropharyngocutaneous Fistulas after Microsurgical Head and Neck Reconstruction: Indications for Management Using the ???Tissue-Plug??? Technique

Evaluation of laryngeal cancer cases treated at our clinic from 2000 to 2005

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