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Fistula laryngectomy

Onur Ismi, Murat Unal, Yusuf Vayisoglu, Mesut Yesilova, Ilter Helvaci, Kemal Gorur, Cengiz Ozcan
Mechanical esophageal closure with stapler during total laryngectomy has been used by various authors to decrease the surgical time and pharyngocutaneous fistula (PCF) rates. In a few of the studies, surgical site infection (SSI) rates are mentioned and none of the studies emphasize the effect of decreased surgical time on postoperative cardiovascular and cerebrovascular complications. In this study, the authors compared the PCF rates, SSI rates, operation times between 30 mechanical stapler and 40 manual esophageal closure during total laryngectomy for laryngeal cancer patients...
November 23, 2016: Journal of Craniofacial Surgery
M Cunnane, S Patil, R Sothinathan, D Walker, M Gaulton, L Pitkin
Surgical voice rehabilitation is an essential dimension of treatment following total laryngectomy. The gold standard is tracheo-oesophageal puncture and speaking valve placement. Whilst offering excellent phonation in many patients, there is a well-documented risk of valve associated fistula formation, the incidence of which varies from 1 to 21% (1) . Risk factors for delayed valve associated tracheo-oesophageal fistula include post chemo-radiotherapy (salvage laryngectomy), oesophageal stricture, persistent fungal infection and poor patient compliance in managing their speaking valve(2) ...
November 24, 2016: Clinical Otolaryngology
Ayotunde James Fasunla, Oluwole Agboola Ogundoyin, Paul Adekunle Onakoya, Onyekwere George Nwaorgu
BACKGROUND: Malignant laryngeal tumors are uncommon. Late presentation of the disease may worsen management outcomes. We described the epidemiologic, clinicopathologic profile, and management outcomes of laryngeal tumors in a tertiary health institution in Nigeria. MATERIALS AND METHODS: An 11-year retrospective review of medical records of patients managed for malignant laryngeal tumor at the University College Hospital, Ibadan, Nigeria, was performed. RESULTS: There were 97 patients comprising 74 (76...
September 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Thomas Frisch
BACKGROUND: The facial artery myomucosal (FAMM) island flap is a cheek flap, pedicled on the facial artery and suitable for small to medium-sized reconstructions of the oral cavity and neighboring areas. A novel transposition of the flap to the hypopharynx after laryngectomy is presented in this report. METHODS: A 58-year-old man, previously irradiated, was laryngopharyngectomized because of a new supraglottic carcinoma. An unexpected need for a flap was solved by tunneling a FAMM island flap lateral to the mandible...
October 5, 2016: Head & Neck
Paul Paddle, Inna Husain, Lauren McHugh, Ramon Franco
OBJECTIVES/HYPOTHESIS: A total laryngectomy (TL) is performed as a primary or salvage therapy for laryngeal carcinoma. Pharyngotomy closure after TL is typically performed using manual sutures. Automatic stapling devices are routinely used in thoracoabdominal surgery, but have not been widely accepted for use in pharyngotomy closure. Previously described closed stapling techniques of pharyngeal closure do not allow direct evaluation of surgical margins and are limited to endolaryngeal disease...
August 22, 2016: Laryngoscope
S Sharma, D A Chaukar, S G Laskar, N Kapre, A Deshmukh, P Pai, P Chaturvedi, A D'Cruz
OBJECTIVE: This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy. METHODS: A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay. RESULTS: The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43...
September 2016: Journal of Laryngology and Otology
Ibrahim Erdim, Ali Ahmet Sirin, Bahadir Baykal, Fatih Oghan, Ali Guvey, Fatma Tulin Kayhan
INTRODUCTION: Tracheoesophageal peristomal fistulae can often be solved by reducing the size of the fistula or replacing the prosthesis; however, even with conservative techniques, leakage around the fistula may continue in total laryngectomy patients. Also, several techniques have been developed to overcome this problem, including injections around the fistula, fistula closure with local flaps, myofascial flaps, or free flaps and fistula closure using a septal perforation silicon button...
July 21, 2016: Brazilian Journal of Otorhinolaryngology
Sophia Nitassi, Jihane Belayachi, Mohammed Chihab, Ilham Rkain, Jalila Benayad, Mohammed Anas Benbouzid, Abdelillah Oujilal, Leila Essakalli
INTRODUCTION: Pharyngocutaneous fistula (PCF) is the most common complication after total laryngectomy. Its incidence is extremely variable, with values ranging from 3% and 65%. The management of this problem considerably increases the length and the cost of hospitalization. The aim of this study is to analyze the incidence, predisposing factors, and outcome of PCF in patients undergoing total laryngectomy in a Moroccan teaching hospital in Rabat, Morocco. MATERIALS AND METHODS: This study is a retrospective study including 136 patients who underwent total laryngectomy for squamous cell carcinoma of the larynx in our institution, between January 2006 and December 2013...
March 2016: Iranian Journal of Otorhinolaryngology
Z Hasan, R C Dwivedi, D A Gunaratne, S A Virk, C E Palme, F Riffat
BACKGROUND AND OBJECTIVES: Management paradigms in laryngeal cancer have shifted to "organ preservation" chemoradiotherapy protocols. In the event of treatment failure, salvage total laryngectomy remains the only curative treatment option. However a comprehensive review of the complications of this procedure has not been reported. METHODS: A systematic review of the literature was performed using keywords "salvage laryngectomy" to retrieve relevant publications between January 2000 and August 2015...
May 27, 2016: European Journal of Surgical Oncology
Kamal Kishor Lakhera, Ashok M Shenoy, P Chavan, K Siddappa
To analyse pharyngocutaneous fistula, post Pectoralis major myocutaneous patch pharnygoplasty, and its association with various tumor, patient and treatment related factors. It is a retrospective study that included 48 patients who underwent laryngectomy and PMMC patch pharyngeal reconstruction from year 2009 to 2013. We studied the previously reported factors that could influence fistula formation such as age, gender, previous radiotherapy, previous tracheostomy, location of tumor, extent of tumor, tumor volume, tumor stage and surgical margins...
September 2015: Indian Journal of Surgical Oncology
Patrick J Schuler, Thomas K Hoffmann, Johannes A Veit, Nicole Rotter, Daniel T Friedrich, Jens Greve, Marc O Scheithauer
INTRODUCTION: Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. METHODS: TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure...
May 16, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Lukas Anschütz, Lluís Nisa, Olgun Elicin, Beat Bojaxhiu, Marco Caversaccio, Roland Giger
Pharyngocutaneous fistula (PCF) is the most cumbersome complication after salvage total laryngectomy (STL) in patients who have been previously irradiated for laryngeal or hypopharyngeal cancer. To assess the fistula rate, risk factors and effects of primary closure with and without pectoralis major myofascial interposition flap (PMMIF) on fistula formation, we conducted a retrospective review. We identified 48 patients from 2004 to 2013 who underwent STL after failure of primary curative (chemo)radiotherapy in laryngeal or hypopharyngeal cancer...
November 2016: European Archives of Oto-rhino-laryngology
Eviatar Friedlander, Paloma Pinacho Martínez, Daniel Poletti Serafini, Carlos Martín-Oviedo, Tomás Martínez Guirado, Bartolomé Scola Yurrita
INTRODUCTION AND OBJECTIVES: Periprosthetic leakage of liquids is a common complication in patients rehabilitated with voice prostheses. Our objective was to describe and review the results of procedures for treating periprosthetic leakage. MATERIALS AND METHODS: This was a retrospective analysis of 41 patients rehabilitated with Provox® 2 voice prostheses between 1997 and 2015. We describe 3 techniques: periprosthetic silicon collar placement, injection of hyaluronic acid into the tracheoesophageal wall and the combination of the 2 techniques...
April 8, 2016: Acta Otorrinolaringológica Española
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
Rani Abu Eta, Ephraim Eviatar, Haim Gavriel
The aim of the study is to examine the utilization of hyperbaric oxygen treatment (HBOT) as an alternative to surgical treatment for non-healing postoperative phayngocutaneous fistula (POPCF). A retrospective study was conducted between 2012 and 2014 of referred patients who had failed conservative treatment for POPCF at other medical centers. Reevaluation at our department was followed by therapeutic management including daily HBOT. Eight male patients with a mean age of 62.3 years were included. The average period of conservative treatment was 1 month before admittance to our department...
March 26, 2016: European Archives of Oto-rhino-laryngology
Xiangmin Zhang, Folin Liu, Xiaolin Lan, Keqing Luo, Fufu Xiao, Shaojin Li
The treatment of pharyngeal fistulas is complicated. It is more difficult to deal with pharyngeal fistula following surgical treatment for hypopharynx carcinoma, particularly in cases of pectoralis major muscle flap repair. The present study describes the case of a 56-year-old man who presented with a highly-differentiated pharyngeal squamous cell carcinoma located at the right side of the hypopharynx. The patient underwent a total laryngectomy and a right functional carotid dissection and tracheostomy; this was followed by post-operative radiotherapy...
March 2016: Oncology Letters
Robert Šifrer, Aleksandar Aničin, Maja Perme Pohar, Miha Žargi, Peter Pukl, Tanja Soklič, Primož Strojan
A pharyngocutaneous fistula is the most common complication following laryngectomy. A wide range of potential risk factors has been suggested. The purpose of this study was to determine the incidence and risk factors for the fistula at the Department of Otorhinolaryngology and Head and Neck Surgery in Ljubljana, Slovenia between 2007 and 2012. Charts from patients treated for head and neck cancer by laryngectomy were retrospectively reviewed. Comprehensive clinicopathologic data were collected including potential risk factors related to the patient, disease, surgery and postoperative period...
October 2016: European Archives of Oto-rhino-laryngology
Dushyant Jaiswal, Prabha Yadav, Vinay Kant Shankhdhar, Rajendra Suresh Gujjalanavar, Prashant Puranik
INTRODUCTION: Tracheoesophageal voice prosthesis is highly effective in providing speech after total laryngectomy. Although it is a safe method, in certain cases dilatation or leakage occurs around the prosthesis that needs closure of tracheoesophageal fistula. Both non-surgical and surgical methods for closure have been described. Surgical methods are used when non-surgical methods fail. We present the use of the sternocleidomastoid musculocutaneous (SCMMC) transposition flap for the closure of tracheoesophageal fistula...
September 2015: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Ashok Muniappan, Douglas J Mathisen
Acquired non-malignant tracheo-oesophageal fistula (TOF) most commonly develops after prolonged intubation or tracheostomy. It may also develop after trauma, oesophagectomy, laryngectomy and other disparate conditions. TOF leads to respiratory compromise secondary to chronic aspiration and pulmonary sepsis. Difficulty with oral intake usually leads to nutritional compromise. After diagnosis, the goals are to eliminate or reduce ongoing pulmonary contamination and to restore proper nutrition. Operative repair of benign TOF is generally performed through a cervical approach...
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Z Saltürk, A Arslanoğlu, E Özdemir, G Yıldırım, İ Aydoğdu, T L Kumral, G Berkiten, Y Atar, Y Uyar
OBJECTIVE: This study investigated the relationship between psychological well-being and different voice rehabilitation methods in total laryngectomy patients. METHODS: The study enrolled 96 patients who underwent total laryngectomy. The patients were divided into three groups according to the voice rehabilitation method used: esophageal speech (24 patients); a tracheoesophageal fistula and Provox 2 voice prosthesis (57 patients); or an electrolarynx (15 patients)...
March 2016: HNO
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