The Novel Use of Flexible Endoscopic Techniques in the Management of Pharyngocutaneous Fistulas

Abstract

Pharyngocutaneous fistula (PCF) is a complication of laryngectomies in 14 to 23% of patients. The rate of spontaneous resolution of small and low-output fistulas has been shown to be 65 to 94% in those who are radiation-naive, with a reduced rate of resolution in patients who were previously radiated as low as 33%. Two patients are presented who underwent total laryngopharyngectomy and anterolateral thigh free flap reconstruction at our institution eventually complicated with PCF. All the pertinent patient data were retrieved through chart review from the records of our institution. The cases presented had a prior history of radiation or chemoradiation complicating the spontaneous resolution of the PCF. Both patients had successful resolution of PCF with the flexible endoscopic techniques presented. This case series highlights the management of small PCFs using flexible endoscopic techniques including over-the-scope clips and Vicryl mesh plugs.

Keywords

pharyngocutaneous fistula - flexible endoscopy - total laryngectomy

Authors' Contribution

All authors had full access to the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

Publication History

Received: 17 November 2020

Accepted: 01 March 2021

Article published online:
23 August 2021

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