Pharyngocutaneous fistula after total laryngectomy: emphasis on lymph node metastases as a new predisposing factor.

Pharyngocutaneous fistula remains the most frequent complication of total laryngectomy despite improved preoperative assessment and postoperative care. Lymph node metastases emerged for the first time as a risk factor for fistula formation. Our experience confirmed that meticulous postoperative care should be paid to the patients who have contributing risk factors and lymph node metastases.