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European Archives of Oto-Rhino-Laryngology

Erschienen in:

29.03.2024 | Head and Neck

Horizontal pharyngeal closure during total laryngectomy reduces rates of pharyngocutaneous fistula

verfasst von: Aris I. Giotakis, Spyridon Potamianos, Zoi Zachou, Evangelos I. Giotakis, Efthymios Kyrodimos

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 6/2024

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Abstract

Purpose

Pharyngocutaneous fistula (PCF) is a possible complication following total laryngectomy (TL), with a mean incidence of 17%. We intended to investigate the effect of pharyngeal closure type during TL on the prevention of PCF.

Methods

We retrospectively reviewed patients that underwent TL with a horizontal pharyngeal closure over a 10-year period. The frequency of PCF clinically, dysphagia, total oral diet, postoperative dilatation of the neopharynx and voice problems were tabulated.

Results

Seventy-seven subjects underwent TL due to laryngeal tumor without pharyngeal extension. Of them, 45 underwent a salvage TL. PCF occurred in 1/77 subjects. The rest of the subjects (76/77) did not develop a PCF, neither in the early nor in the late postoperative phase. All subjects (15/77) that underwent implantation of a voice prosthesis were satisfied with their voice. No subject complained about dysphagia. Every subject achieved total oral diet.

Conclusion

The horizontal pharyngeal closure is a safe pharyngeal closure technique during TL, reduces PCF rates (< 2%), results in excellent voice rehabilitation and swallowing function, and can also be used during salvage TL instead of a major pectoral flap. This type of closure should be used only in selected patients with laryngeal disease without pharyngeal extension.

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Titel: Horizontal pharyngeal closure during total laryngectomy reduces rates of pharyngocutaneous fistula
verfasst von: Aris I. Giotakis
Spyridon Potamianos
Zoi Zachou
Evangelos I. Giotakis
Efthymios Kyrodimos
Publikationsdatum: 29.03.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 6/2024
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08593-1

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Horizontal pharyngeal closure during total laryngectomy reduces rates of pharyngocutaneous fistula