evention and management of pharyngeal fistula after total or near-total laryngectomy

abstractJECTIVE To discuss the role of surgical skill and , pre and post-operative care in decrease incidence of pharyngeal fistula after total and near-total laryngectomy. METHODS Three hundred and sixty five cases with laryngeal cancer were underwent radical laryngeal excisions (333 total laryngectomy and 32 near-total laryngectomy). RESULTS Pharyngeal fistula was occurred in 27 of 333 cases after total laryngectomy (incidence 8.1 %) and 1 of 32 cases after near-total laryngectomy (incidence 3.1 %). CONCLUSION The standardized mucosal suturing of hypopharyngeal defect, continuous neck suction after operation are important factors to reduce the incidence of pharyngeal fistula. Pharyngeal fistula of near-total laryngectomy is lesser than that of total laryngectomy might be due to near-total laryngectomy preserving one side of pyriform sinus mucosa and less hypopharyngeal defect.