Management of Pharyngocutaneous Fistula
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- Category: Vol. 85, June 2017
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Management of Pharyngocutaneous Fistula, MOHAMED ANWAR, HAZEM DEWIDAR, AHMED NASSAR and AHMED YOUSEF
Abstract
Background: Early recognition of pharyngocutaneous fistula is critical in avoiding secondary wound complications and other more severe outcomes. Management of pharyngo-cutaneous fistula can take a conservative (secondary intention) or surgical pathway (primary intention) dependent on the size and severity of presentation.
Methods: This study included 34 patients who underwent total laryngectomy and developed pharyngocutaneous fistula (PCF) postoperatively, oral feeding was suspended and NG tube feeding was continued for a while to allow closure of the fistula. Control of wound infection was done by frequent dressing and give proper antibiotics according to culture and sensitivity test. If the fistula persists for 2 months, reconstruc-tive procedures may be carried out with pectoralis major myocutaneous flap or any flap based on the preference of the surgeon and the circumstances surrounding the patient.
Results: In our study 28 patients (82.4%) the fistula was treated conservatively. 4 patients (11.7%) were treated by flaps (pectoralis major and deltopectoral), 3 patients (8.8%) were treated by pectoralis major myocutaneous flap and 1 patient (2.94%) was treated by deltopectoral flap.
Conclusion: Conservative management for PCF should continue for 8 weeks and if fistula persists so it should be closed surgically.