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pharyngo fistula

Julia Thierauf, Paul Severin Wiggenhauser, Thomas Karl Hoffmann, Jens Greve, Marc Scheithauer, Johannes Adrian Veit
OBJECTIVE: In vacuum wound therapy (VAC) a negative pressure can continuously clean effusions and enhance the formation of granulation tissue significantly. In visceral, trauma and burns surgery this technique is used frequently in critical wounds. In the head and neck area there is limited experience and publications. Especially in the combined use of split-thickness-skin grafts (STSG) and VAC there is no published evidence. MATERIAL AND METHODS: A retrospective database analysis was done and resulted in 36 single VAC therapies in 13 patients...
May 7, 2018: Laryngo- Rhino- Otologie
M Abu-Serriah, S Loughran
Circumferential defects of the hypopharynx are a reconstructive challenge. Various local, regional and free flaps have been described with each having advantages and disadvantages in terms of functional outcomes. The fasciocutaneous radial forearm free flap (RFFF) is one of the most common free flaps used for reconstructing circumferential hypopharyngeal defects. The skin paddle is pliable and reasonably matches the native hypopharyngeal wall. It is easy to raise, has predictable vascular anatomy and a long pedicle...
February 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Asok K Saha, Saikat Samaddar, Avijit Choudhury, Abir Chaudhury, Nirmalya Roy
Larynx is the second most common site for cancer in the upper aerodigestive tract. One of the dreaded complications following total laryngectomy has been pharyngo cutaneous fistula (PCF). PCF merits special attention due to its significant negative impact on the recovery process. Total laryngectomy profoundly alters speech. Effective voice restoration is essential for the rehabilitation of these patients. Inadequate consensus exists as to the best technique of pharyngeal repair to decrease incidence of PCF and ensure good quality voice following total laryngectomy...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
B Walton, J Vellucci, P B Patel, K Jennings, S McCammon, M P Underbrink
OBJECTIVE: The purpose of this study was to find a correlation between closure technique in pharyngeal closure and outcomes of both pharyngocutaneous fistula and post-laryngectomy stricture after laryngectomy. STUDY DESIGN: Retrospective Chart Review. METHODS: We retrospectively reviewed a total of 151 patients over a 20-year period from January 1994 to December of 2013 who underwent primary pharyngeal reconstruction after total laryngectomy specifically looking at the closure technique in relation to pharyngo-cutaneous fistula (PCF) and post-laryngectomy stricture postoperatively...
February 2018: Clinical Otolaryngology
José A González-García, Carlos M Chiesa-Estomba, Jon A Sistiaga, Ekhiñe Larruscain, Leire Álvarez, Xabier Altuna
INTRODUCTION: The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended. MATERIAL AND METHODS: We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours...
January 2018: Acta Otorrinolaringológica Española
Virginie Achim, Jasper Bash, Alia Mowery, Alexander R Guimaraes, Ryan Li, Josh Schindler, Mark Wax, Peter Andersen, Daniel Clayburgh
No abstract text is available yet for this article.
December 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
Ottorino Perrone, Valentina Tassi, Benedetta Mattioli, Niccolò Daddi, Mariella Uneddu, Ignazio Borghesi, Sandro Mattioli
OBJECTIVES: Pharyngo-oesophageal perforation is a rare, life-threatening complication of anterior cervical discectomy and fusion surgery; its management remains poorly defined. We reviewed our experience to understand the treatment of this dreadful complication. METHODS: Data regarding the demographics, clinical course, diagnosis, management and outcomes of 15 cases of pharyngo-oesophageal perforations in 14 patients were collected during the period from 2003 to 2016...
January 2017: European Journal of Cardio-thoracic Surgery
Takayuki Imai, Takahiro Goto, Ko Matsumoto, Koreyuki Kurosawa, Yukinori Asada, Shigeru Saijo, Kazuto Matsuura
Free jejunal transfer is the main technique used for reconstructing a circumferential defect caused by total pharyngo-laryngo-cervical-esophagectomy in certain cancer cases. We report a rare case of severe late-onset dysphagia caused by autonomous spastic peristalsis, which led to complete obstruction of the free jejunal route. A 70-year-old man underwent treatment for hypopharyngeal cancer involving total pharyngolaryngectomy with free jejunal transfer. After uneventful peri- and postoperative recovery, he developed sudden-onset severe dysphagia 22 months later...
December 2016: Auris, Nasus, Larynx
F Haubner, H G Gassner, J C Pérez Álvarez
Wound healing complications in irradiated tissues represent a major clinical challenge. Fistula or even major vessel rupture may occur. The injection of adipose tissue derived stem cells seem to be a promising therapeutical strategy. The article describes the clinical case of a patient suffering from a pharyngo-cutaneous fistula after laryngectomy and radiotherapy. The patient was successfully treated by the injection of fat tissue.
April 2016: Laryngo- Rhino- Otologie
Erika Crosetti, Andrea Fulcheri, Giovanni Succo
INTRODUCTION: We present a rare case of pharyngo-jugular fistula in a patient who underwent salvage total laryngectomy after organ-sparing radiochemotherapy. CASE PRESENTATION: A 77-year-old Caucasian man underwent total laryngectomy and bilateral neck dissection as salvage surgery after the failure of radiochemotherapy at another hospital. Thirty-five days after surgery, he was admitted to our emergency room for fever and massive oral bleeding during meals. Videopanendoscopy showed the presence of a large clot at the base of his tongue, while a neck computed tomography scan showed a pharyngo-jugular fistula with the presence of air in the left internal jugular vein...
October 6, 2015: Journal of Medical Case Reports
Jiakun Su, Feng Zhao, Xiaolin Wei, Jiping Su
OBJECTIVE: To investigate the relative factors of pharyngo cutaneou fistulas after larynx cancer and lower pharynx cancer surgery. METHOD: The clinical datas of 87 larynx cancer patients and lower pharynx cancer patients admitted were retrospectively analyzed. According to the type of postoperative complications all cases could be divided into pharyngo cutaneou fistulas group and no pharyngo cutaneou fistulas group. Thirty-eight kinds of factors,including age, clinical stage, plasma electrolytes level and type of procedure are in the multivariate analysis, and the variability indicators are in binary-regression analysis...
April 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Anirudh Shukla, Vivek Dudeja
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 Pharyngo-cutaneous 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"...
March 2015: Indian Journal of Otolaryngology and Head and Neck Surgery
E Loaec, P-Y Vaillant, L Bonne, R Marianowski
INTRODUCTION: Pharyngocutaneous fistula is a well-known complication of head and neck cancer surgery.The purpose of this study was to determine the value of negative-pressure wound therapy (NPWT) for the treatment of these fistulas. NPWT is used in many fields of medicine, but its use in otorhinolaryngology has been rarely reported. NPWT is a cost-effective means to accelerate wound healing. PATIENTS AND METHODS: A single-centre retrospective study was conducted on 7 patients with pharyngo-cutaneous fistula following surgery for squamous cell carcinoma between January 2011 and April 2013...
December 2014: European Annals of Otorhinolaryngology, Head and Neck Diseases
Ngian Chye Tan, Pao-Yuan Lin, Pao-Jen Kuo, Yun-Ta Tsai, Yen-Chou Chen, Khanh Thien Nguyen, Yur-Ren Kuo
BACKGROUND: The three commonly used free flaps for circumferential pharyngeal reconstruction after total pharyngo-laryngectomy are the radial forearm flap (RFF), the anterolateral thigh (ALT) flap, and the jejunum flap. This study was to objectively compare three different flaps for pharyngeal reconstruction during the past 10 years. Stricture and fistula were assessed using esophagogram and esophagoscopy. METHODS: Forty-five patients with pharyngeal reconstructions had esophagram and esophagoscopy done postoperatively to assess for strictures and fistulas...
July 2015: Microsurgery
Fenglin Sun, Xuezhong Li, Dapeng Lei, Tong Jin, Dayu Liu, Hui Zhao, Qiuan Yang, Guojun Li, Xinliang Pan
OBJECTIVES: There is no generally accepted treatment strategy for cervical esophageal carcinoma. The purpose of this study was to evaluate the operative outcomes of reconstruction after resection of cervical esophageal and hypopharynx-esophagus junction carcinoma with larynx preservation. METHODS: We retrospectively reviewed the data of 79 patients with carcinoma of the hypopharynx-esophagus junction and cervical esophagus. Transhiatal total esophagectomy without thoracotomy was carried out in 67 patients who underwent gastric pull-up (GP) or colon interposition (CI) techniques...
2014: International Journal of Clinical and Experimental Medicine
Adel Denewer, Ashraf Khater, Mohamed T Hafez, Osama Hussein, Sameh Roshdy, Fayez Shahatto, Waleed Elnahas, Sherif Kotb, Khaled Mowafy
BACKGROUND: The aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma. METHODS: One hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment. RESULTS: Pectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases...
2014: World Journal of Surgical Oncology
S Anderson, D Hogan, B Panizza
OBJECTIVES: To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. STUDY DESIGN: A prospective, observational study of 43 patients undergoing total laryngectomy. METHODS: Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation...
July 2014: Journal of Laryngology and Otology
María Fernández-Prada, Juan M Palomeque-Vera, Javier Gómez-Hervás, José Guillén Solvas, Manuel Sainz Quevedo, Herminia Revelles Suárez
INTRODUCTION AND OBJECTIVES: Pharyngo-cutaneous fistula (PCF) is one of the main problems for patients undergoing total laryngectomy. There are many risk factors described and associated with the appearance of PCF; however, some of these are currently under discussion. The aim of this work is to analyse the incidence of PCF, hospital stay and associated risk factors in patients undergoing total laryngectomy in a secondary hospital. METHODS: This was an observational study in a retrospective cohort...
January 2014: Acta Otorrinolaringológica Española
Bernhard G Weiss, Friedrich Ihler, Christoph Matthias, Martin Canis
After laryngectomy or lateral pharyngotomy for treatment of laryngeal or hypopharyngeal cancer the occurrence of a pharyngo-cutaneous fistula is a challenging complication. Especially after previous radiotherapy and expanded surgical resections of mucosa the management is demanding. Besides the prolonged hospital stay, increased treatment costs and reduced quality of life, a delayed adjuvant treatment follows the development of a fistula. Treatment strategies range from conservative procedures comprising parenteral nutrition, antibiotics and local wound care to primary surgical closure or reconstructive tissue transfer...
March 2014: American Journal of Otolaryngology
Mark Sayles, David G Grant
OBJECTIVES/HYPOTHESIS: Concurrent chemoradiotherapy is the gold-standard nonsurgical organ-preservation treatment for advanced laryngeal carcinoma. Total laryngectomy (TL) is increasingly reserved for surgical salvage. Salvage surgery is associated with more complications than primary surgery. A systematic review and meta-analysis was undertaken to establish the impact of organ preservation protocols on pharyngo-cutaneous fistula incidence following TL, and to synthesize evidence on the role of "onlay" prophylactic tissue flaps in reducing this complication in salvage TL...
May 2014: Laryngoscope
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