Endoscopic Repair of Pharyngocutaneous Fistula Following Laryngectomy

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Pharyngocutaneous fistula (PCF) is a typical complication after total laryngectomy. It is managed predominantly via conservative techniques, but in cases of a large orifice or a substantial loss of surrounding soft tissue, surgical management is mandatory. Our aim was to apply a new endoscopic surgical approach for closure of a pharyngocutaneous fistula. We report a case of a 61-year-old patient, who had been subjected to total laryngectomy with partial resection of tongue base and postoperative radiotherapy for advanced laryngeal carcinoma. Pharyngocutaneous fistula developed two years after the initial treatment. Barium swallow radiographs revealed a fistula between the neopharynx and the skin at the C2-C4 level. An endoscopic surgical repair was performed. Fat tissue harvested from the abdomen was injected into the area surrounding the pharyngeal opening of the fistula. The opening was sclerosed and sutured. The patient resumed a normal diet after several days and the fistula did not recur throughout the follow-up period. The management of pharyngocutaneous fistula is mainly conservative and only in therapy-refractory cases, surgery is considered. In well-selected cases, an endoscopic approach can be used. Autologous fat injection around the hypopharyngeal opening of the PCF may be one of the possible options.

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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