[Pharyngocutaneous fistula following total laryngectomy in patients with advanced stage hypopharyngeal or laryngeal carcinomas].

OBJECTIVE

To investigate the locations, predisposing factors, managements and outcomes of pharyngocutaneous fistula (PCF) following total laryngectomy in patients with advanced stage hypopharyngeal or laryngeal carcinomas.

METHOD: One hundred and ninety-eight patients with advanced hypopharyngeal or laryngeal carcinomas who were performed by total laryngectomy were analyzed retrospectively. The multiple predisposing factors, including age, sex, preoperative radiotherapy, previous tracheostomy, stage, differentiation, site, neck dissection and postoperative fever, were analyzed.

RESULT: The incidence of PCF was 16.7%. The situations of orificium fistulae lied in 69.7% superior segment, 21.2% inferior and 9.1% middle segment respectively. The incidence of PCF was 24.7% in hypopharynx and 11.6% in larynx respectively. There were significant differences between them. The differences of postoperative continuous fever beyond 5 days were statistical significance between the group of PCF and no PCF. In them, 28 patients of PCF were healed spontaneously and 5 of them were healed by surgical operation.

CONCLUSION

PCF is often situated in tongue base and post-superior of trachea stoma. Tumor locations and postoperative fever are important predisposition.