Incidence and risk factors of pharyngocutaneus fistula formation after total laryngectomy. Review
Abstract Introduction and objective: The pharyngocutaneous fistula is a troublesome complication after total laryngectomy, increasing morbidity and mortality. We aimed to determine the incidence of pharyngocutaneus fistula after total laryngectomy and to define the possible predictors for pharyngocutaneus fistula formation. Method: We conducted a review of 31 articles with a total of 1100 patients, to evaluate the incidence of fistula in patients with total laryngectomy and risks factors involved. Results: The overall incidence of pharyngocutaneus fistula is 22,3%, and ranges from 3 to 65%. The review revealed that prior radiation treatment was the most common antecedent, following this associated comorbidity, hypoalbuminemia, anemia, and history of tracheotomy prior to laryngectomy. Discussion: Among the series studied, there is significant heterogeneity in the results, because although irradiated patients have a greater number of pharyngostomas, in some studies no relationship was found, which could explain the association with other risk factors. Conclusions: The incidence of pharyngocutaneus fistula is very variable and there are a large number of risk factors involved, the most frequent is radiotherapy associated or not with chemotherapy.
- Referencias
- Cómo citar
- Del mismo autor
- Métricas
1. Busoni M, Deganello A, Gallo O. Pharyngocutaneous fistula following total laryngectomy: analysis of risk factors, prognosis and treatment modalities. Acta Otorhinolaryngol Ital. 2015;35(6):400-5.
2. Saki N, Nikakhlagh S, Kazemi M. Pharyngocutaneous fistula after laryngectomy: incidence, predisposing factors, and outcome. Arch Iran Med. 2008;11(3):314-7.
3. Toyama F, Aparecido R, Ferrari MA, Araki D, Cernea CR, Garcia L. Pharyngocutaneous fistula following total laryngectomy. Braz. j. Otorhinolaryngoly 2012;78 (6):94-8.
4. Pantvaidya GH, Raina S, Mondal A, et al. Total laryngectomy: Surgical morbidity and outcomes - A case series. Indian J Cancer. 2017;54(4):621-5.
5. Asif Ali Arain, Mubasher Ikram, Shabbir Akhtar, Muhammad Shaheryar Ahmed Rajput, Mohammad Adeel, Moaz Maqbool Choudhary. Frequency and predisposing factors of pharyngocutaneous fistula after total laryngectomy. Egyptian Journal of Ear, Nose, Throat and Allied Science 2013;14 (2):103-6.
6. Shams El-din, Mohammed. The incidence and risk factors of pharyngocutaneous fistula after total laryngectomy. Al-azhar Assiut Medical Journal. 2014:12.
7. Suzuki S, Yasunaga H, Matsui H, Horiguchi H, Fushimi K, Yamasoba T. Pharyngocutaneous fistula and delay in free oral feeding after pharyngolaryngectomy for hypopharyngeal cancer. Head Neck. 2016;38 Suppl 1:E625-E630.
8. Aires FT, Dedivitis RA, Castro MA, Ribeiro DA, Cernea CR, Brandão LG. Fístula faringocutânea após laringectomia total [Pharyngocutaneous fistula following total laryngectomy]. Braz J Otorhinolaryngol. 2012;78(6):94-8.
9. Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC. Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence?. Eur Arch Otorhinolaryngol. 2004;261(2):61-7.
10. Mattioli F, Bettini M, Molteni G, et al. Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status. Acta Otorhinolaryngol Ital. 2015;35(4):243-8.
11. Benson EM, Hirata RM, Thompson CB, et al. Pharyngocutaneous fistula after total laryngectomy: a single-institution experience, 2001-2012. Am J Otolaryngol. 2015;36(1):24-31.
12. Nitassi S, Belayachi J, Chihab M et al. Evaluation of post laryngectomy pharyngocutaneous fistula risk factors. Iran J Otorhinolaryngol. 2016;28(85):141–7.
13. Kiliç C, Tuncel U, Cömert E. Pharyngocutaneous fistulae after total laryngectomy: analysis of the risk factors and treatment approaches. B-ENT. 2015;11(2):95-100.
14. Akduman D, Naibo?lu B, Uslu C, et al. Total larenjektomi sonrasi farengokutanöz fistül: Sikli?i, etkileyen faktörler ve tedavi yakla?imi [Pharyngocutaneous fistula after total laryngectomy: incidence, predisposing factors, and treatment]. Kulak Burun Bogaz Ihtis Derg. 2008;18(6):349-54.
15. Hall FT, O'Brien CJ, Clifford AR, McNeil EB, Bron L, Jackson MA. Clinical outcome following total laryngectomy for cancer. ANZ J Surg. 2003;73(5):300-5.
16. Lansaat L, van der Noort V, Bernard SE, et al. Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit. Eur Arch Otorhinolaryngol. 2018;275(3):783-94.
17. Güçlü E, Pinar E, Oncel S, Calli C. Total larenjektomi sonrasinda farengokutanöz fistül sikli?i ve risk faktörlerinin analizi [Pharyngocutaneous fistula after total laryngectomy: incidence and analysis of risk factors]. Kulak Burun Bogaz Ihtis Derg. 2007;17(5):260-4.
18. Asl?er NGY, Do?an E, Asl?er M, ?kiz AÖ. Pharyngocutaneous Fistula after Total Laryngectomy: Risk Factors with Emphasis on Previous Radiotherapy and Heavy Smoking. Turk Arch Otorhinolaryngol. 2016;54(3):91-8.
19. Timmermans AJ, Lansaat L, Theunissen EA, Hamming-Vrieze O, Hilgers FJ, van den Brekel MW. Predictive factors for pharyngocutaneous fistulization after total laryngectomy. Ann Otol Rhinol Laryngol. 2014;123(3):153-61.
20. Dedivitis RA, Ribeiro KC, Castro MA, Nascimento PC. Pharyngocutaneous fistula following total laryngectomy. Acta Otorhinolaryngol Ital. 2007;27(1):2-5.
21. Sousa Ade A, Porcaro-Salles JM, Soares JM, et al. Predictors of salivary fistula after total laryngectomy. Rev Col Bras Cir. 2013;40(2):98-103.
22. Fernández-Prada M, Palomeque-Vera JM, Gómez-Hervás J, Guillén Solvas J, Sainz Quevedo M, Revelles Suárez H. Incidencia, estancia hospitalaria y factores de riesgo asociados a la aparición de fístula faringocutánea poslaringectomía [Incidence, hospital stay and risk factors associated with the occurrence of pharyngo-cutaneous fistula after total laryngectomy]. Acta Otorrinolaringol Esp. 2014;65(1):22-6.
23. White HN, Golden B, Sweeny L, Carroll WR, Magnuson JS, Rosenthal EL. Assessment and incidence of salivary leak following laryngectomy. Laryngoscope. 2012;122(8):1796-19.
24. Süslü N, ?efik Ho?al A. Early oral feeding after total laryngectomy: Outcome of 602 patients in one cancer center. Auris Nasus Larynx. 2016;43(5):546-50.
25. Cavalot AL, Gervasio CF, Nazionale G, et al. Pharyngocutaneous fistula as a complication of total laryngectomy: review of the literature and analysis of case records. Otolaryngol Head Neck Surg. 2000;123(5):587-92.
26. Boscolo-Rizzo P, De Cillis G, Marchiori C, Carpenè S, Da Mosto MC. Multivariate analysis of risk factors for pharyngocutaneous fistula after total laryngectomy. Eur Arch Otorhinolaryngol. 2008;265(8):929-6.
27. Ganly I, Patel S, Matsuo J, et al. Postoperative complications of salvage total laryngectomy. Cancer. 2005;103(10):2073-81.
28. Mäkitie AA, Niemensivu R, Hero M, et al. Pharyngocutaneous fistula following total laryngectomy: a single institution's 10-year experience. Eur Arch Otorhinolaryngol. 2006;263(12):1127-30.
29. Galli J, De Corso E, Volante M, Almadori G, Paludetti G. Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy. Otolaryngol Head Neck Surg. 2005;133(5):689-94.
30. Sarra LD, Rodríguez JC, García Valea M, Bitar J, Da Silva A. Fístula tras laringectomía total. Estudio retrospectivo y revisión bibliográfica [Fistula following total laryngectomy. Retrospective study and bibliographical review]. Acta Otorrinolaringol Esp. 2009;60(3):186-9.
31. Virtaniemi JA, Kumpulainen EJ, Hirvikoski PP, Johansson RT, Kosma VM. The incidence and etiology of postlaryngectomy pharyngocutaneous fistulae. Head Neck. 2001;23(1):29-33.
32. Lebo NL, Caulley L, Alsaffar H, Corsten MJ, Johnson-Obaseki S. Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy: analysis of a large multi-institutional patient cohort. J Otolaryngol Head Neck Surg. 2017;46(1):54.
33. Liang JW, Li ZD, Li SC, Fang FQ, Zhao YJ, Li YG. Pharyngocutaneous fistula after total laryngectomy: A systematic review and meta-analysis of risk factors. Auris Nasus Larynx. 2015;42(5):353-9.
34. Redaelli de Zinis LO, Ferrari L, Tomenzoli D, et al. Postlaryngectomypharyngocutaneous fistula: incidence, predisposing factors, and therapy. Head Neck 1999;21(2):131– 8.
35. Trinidad G, Luengo JM, Marcos M, Pardo G, González A, Pino A, et al. Utilidad del soporte nutricional en pacientes con fístula faringocutánea. Act Otol Esp. 2005;56: 25-30.
36. Schwartz SR, Yueh B, Maynard C, Daley J, Henderson W, Khuri SF. Predictors of wound complications after laryngectomy: A study of over 2000 patients. Otolaryngol Head Neck Surg. 2004;131:61–8.
37. Lebo NL, Caulley L, Alsaffar H, Corsten MJ, Johnson-Obaseki S. Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy: analysis of a large multi-institutional patient cohort. J Otolaryngol Head Neck Surg. 2017;46(1):54.
38. Soylu L, Kiroglu M, Aydogan B, Cetik F, Kiroglu F, Akcali C, et al. Pharyngocutaneous fistula following laryngectomy. Head Neck. 1998;20:22-5.
39. Horgan EC, Dedo HH. Prevention of major and minor fistulae after laryngectomy. Laryngoscope 1979;89: 251–60.
40. Violaris N, Bridger M. Prophylactic antibiotics and post larygectomy pharyngocutaneous fistulae. J Laryngol Otol 1990;104:225–8.
41. Saydam L, Kalcioglu T, Kizilay A. Early oral feeding following total laryngectomy. Am J Otolaryngol. 2002;23(5):277-81.
42. Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck. 2012; 34:580–8.
2. Saki N, Nikakhlagh S, Kazemi M. Pharyngocutaneous fistula after laryngectomy: incidence, predisposing factors, and outcome. Arch Iran Med. 2008;11(3):314-7.
3. Toyama F, Aparecido R, Ferrari MA, Araki D, Cernea CR, Garcia L. Pharyngocutaneous fistula following total laryngectomy. Braz. j. Otorhinolaryngoly 2012;78 (6):94-8.
4. Pantvaidya GH, Raina S, Mondal A, et al. Total laryngectomy: Surgical morbidity and outcomes - A case series. Indian J Cancer. 2017;54(4):621-5.
5. Asif Ali Arain, Mubasher Ikram, Shabbir Akhtar, Muhammad Shaheryar Ahmed Rajput, Mohammad Adeel, Moaz Maqbool Choudhary. Frequency and predisposing factors of pharyngocutaneous fistula after total laryngectomy. Egyptian Journal of Ear, Nose, Throat and Allied Science 2013;14 (2):103-6.
6. Shams El-din, Mohammed. The incidence and risk factors of pharyngocutaneous fistula after total laryngectomy. Al-azhar Assiut Medical Journal. 2014:12.
7. Suzuki S, Yasunaga H, Matsui H, Horiguchi H, Fushimi K, Yamasoba T. Pharyngocutaneous fistula and delay in free oral feeding after pharyngolaryngectomy for hypopharyngeal cancer. Head Neck. 2016;38 Suppl 1:E625-E630.
8. Aires FT, Dedivitis RA, Castro MA, Ribeiro DA, Cernea CR, Brandão LG. Fístula faringocutânea após laringectomia total [Pharyngocutaneous fistula following total laryngectomy]. Braz J Otorhinolaryngol. 2012;78(6):94-8.
9. Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC. Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence?. Eur Arch Otorhinolaryngol. 2004;261(2):61-7.
10. Mattioli F, Bettini M, Molteni G, et al. Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status. Acta Otorhinolaryngol Ital. 2015;35(4):243-8.
11. Benson EM, Hirata RM, Thompson CB, et al. Pharyngocutaneous fistula after total laryngectomy: a single-institution experience, 2001-2012. Am J Otolaryngol. 2015;36(1):24-31.
12. Nitassi S, Belayachi J, Chihab M et al. Evaluation of post laryngectomy pharyngocutaneous fistula risk factors. Iran J Otorhinolaryngol. 2016;28(85):141–7.
13. Kiliç C, Tuncel U, Cömert E. Pharyngocutaneous fistulae after total laryngectomy: analysis of the risk factors and treatment approaches. B-ENT. 2015;11(2):95-100.
14. Akduman D, Naibo?lu B, Uslu C, et al. Total larenjektomi sonrasi farengokutanöz fistül: Sikli?i, etkileyen faktörler ve tedavi yakla?imi [Pharyngocutaneous fistula after total laryngectomy: incidence, predisposing factors, and treatment]. Kulak Burun Bogaz Ihtis Derg. 2008;18(6):349-54.
15. Hall FT, O'Brien CJ, Clifford AR, McNeil EB, Bron L, Jackson MA. Clinical outcome following total laryngectomy for cancer. ANZ J Surg. 2003;73(5):300-5.
16. Lansaat L, van der Noort V, Bernard SE, et al. Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit. Eur Arch Otorhinolaryngol. 2018;275(3):783-94.
17. Güçlü E, Pinar E, Oncel S, Calli C. Total larenjektomi sonrasinda farengokutanöz fistül sikli?i ve risk faktörlerinin analizi [Pharyngocutaneous fistula after total laryngectomy: incidence and analysis of risk factors]. Kulak Burun Bogaz Ihtis Derg. 2007;17(5):260-4.
18. Asl?er NGY, Do?an E, Asl?er M, ?kiz AÖ. Pharyngocutaneous Fistula after Total Laryngectomy: Risk Factors with Emphasis on Previous Radiotherapy and Heavy Smoking. Turk Arch Otorhinolaryngol. 2016;54(3):91-8.
19. Timmermans AJ, Lansaat L, Theunissen EA, Hamming-Vrieze O, Hilgers FJ, van den Brekel MW. Predictive factors for pharyngocutaneous fistulization after total laryngectomy. Ann Otol Rhinol Laryngol. 2014;123(3):153-61.
20. Dedivitis RA, Ribeiro KC, Castro MA, Nascimento PC. Pharyngocutaneous fistula following total laryngectomy. Acta Otorhinolaryngol Ital. 2007;27(1):2-5.
21. Sousa Ade A, Porcaro-Salles JM, Soares JM, et al. Predictors of salivary fistula after total laryngectomy. Rev Col Bras Cir. 2013;40(2):98-103.
22. Fernández-Prada M, Palomeque-Vera JM, Gómez-Hervás J, Guillén Solvas J, Sainz Quevedo M, Revelles Suárez H. Incidencia, estancia hospitalaria y factores de riesgo asociados a la aparición de fístula faringocutánea poslaringectomía [Incidence, hospital stay and risk factors associated with the occurrence of pharyngo-cutaneous fistula after total laryngectomy]. Acta Otorrinolaringol Esp. 2014;65(1):22-6.
23. White HN, Golden B, Sweeny L, Carroll WR, Magnuson JS, Rosenthal EL. Assessment and incidence of salivary leak following laryngectomy. Laryngoscope. 2012;122(8):1796-19.
24. Süslü N, ?efik Ho?al A. Early oral feeding after total laryngectomy: Outcome of 602 patients in one cancer center. Auris Nasus Larynx. 2016;43(5):546-50.
25. Cavalot AL, Gervasio CF, Nazionale G, et al. Pharyngocutaneous fistula as a complication of total laryngectomy: review of the literature and analysis of case records. Otolaryngol Head Neck Surg. 2000;123(5):587-92.
26. Boscolo-Rizzo P, De Cillis G, Marchiori C, Carpenè S, Da Mosto MC. Multivariate analysis of risk factors for pharyngocutaneous fistula after total laryngectomy. Eur Arch Otorhinolaryngol. 2008;265(8):929-6.
27. Ganly I, Patel S, Matsuo J, et al. Postoperative complications of salvage total laryngectomy. Cancer. 2005;103(10):2073-81.
28. Mäkitie AA, Niemensivu R, Hero M, et al. Pharyngocutaneous fistula following total laryngectomy: a single institution's 10-year experience. Eur Arch Otorhinolaryngol. 2006;263(12):1127-30.
29. Galli J, De Corso E, Volante M, Almadori G, Paludetti G. Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy. Otolaryngol Head Neck Surg. 2005;133(5):689-94.
30. Sarra LD, Rodríguez JC, García Valea M, Bitar J, Da Silva A. Fístula tras laringectomía total. Estudio retrospectivo y revisión bibliográfica [Fistula following total laryngectomy. Retrospective study and bibliographical review]. Acta Otorrinolaringol Esp. 2009;60(3):186-9.
31. Virtaniemi JA, Kumpulainen EJ, Hirvikoski PP, Johansson RT, Kosma VM. The incidence and etiology of postlaryngectomy pharyngocutaneous fistulae. Head Neck. 2001;23(1):29-33.
32. Lebo NL, Caulley L, Alsaffar H, Corsten MJ, Johnson-Obaseki S. Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy: analysis of a large multi-institutional patient cohort. J Otolaryngol Head Neck Surg. 2017;46(1):54.
33. Liang JW, Li ZD, Li SC, Fang FQ, Zhao YJ, Li YG. Pharyngocutaneous fistula after total laryngectomy: A systematic review and meta-analysis of risk factors. Auris Nasus Larynx. 2015;42(5):353-9.
34. Redaelli de Zinis LO, Ferrari L, Tomenzoli D, et al. Postlaryngectomypharyngocutaneous fistula: incidence, predisposing factors, and therapy. Head Neck 1999;21(2):131– 8.
35. Trinidad G, Luengo JM, Marcos M, Pardo G, González A, Pino A, et al. Utilidad del soporte nutricional en pacientes con fístula faringocutánea. Act Otol Esp. 2005;56: 25-30.
36. Schwartz SR, Yueh B, Maynard C, Daley J, Henderson W, Khuri SF. Predictors of wound complications after laryngectomy: A study of over 2000 patients. Otolaryngol Head Neck Surg. 2004;131:61–8.
37. Lebo NL, Caulley L, Alsaffar H, Corsten MJ, Johnson-Obaseki S. Peri-operative factors predisposing to pharyngocutaneous fistula after total laryngectomy: analysis of a large multi-institutional patient cohort. J Otolaryngol Head Neck Surg. 2017;46(1):54.
38. Soylu L, Kiroglu M, Aydogan B, Cetik F, Kiroglu F, Akcali C, et al. Pharyngocutaneous fistula following laryngectomy. Head Neck. 1998;20:22-5.
39. Horgan EC, Dedo HH. Prevention of major and minor fistulae after laryngectomy. Laryngoscope 1979;89: 251–60.
40. Violaris N, Bridger M. Prophylactic antibiotics and post larygectomy pharyngocutaneous fistulae. J Laryngol Otol 1990;104:225–8.
41. Saydam L, Kalcioglu T, Kizilay A. Early oral feeding following total laryngectomy. Am J Otolaryngol. 2002;23(5):277-81.
42. Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck. 2012; 34:580–8.
Sanz-Sánchez, C. I., Kraemer-Baeza, E., Aguilar-Conde, M. D., Flores-Carmona, E., & Cazorla-Ramos, O. E. (2020). Incidence and risk factors of pharyngocutaneus fistula formation after total laryngectomy. Review. Revista ORL, 12(1), 55–65. https://doi.org/10.14201/orl.23703
Most read articles by the same author(s)
- Cristina Isabel Sanz-Sánchez, José Antonio Pérez-Arcos, Jesús Carlos Verge-González, Óscar Emilio Cazorla-Ramos, Sudden Sensorineural Hearing Loss and COVID-19. Systematic Review , Revista ORL: Vol. 13 No. 4 (2022)
- Cristina Isabel Sanz-Sánchez, Óscar Emilio Cazorla Ramos, Sofía Valle Olsen, Jesús Verge González, José Antonio Pérez Arcos, Treatment of dysphagia Oculopharyngeal Muscular Dystrophy. Systematic review , Revista ORL: Vol. 12 No. 3 (2021)
- Cristina Isabel Sanz-Sánchez, Else Kraemer-Baeza, Eva Flores-Carmona, Maria Dolores Aguilar-Conde, Oscar Emilio Cazorla-Ramos, Pectoralis major myocutaneous flap for faringeal defects reconstruction. Case report , Revista ORL: Vol. 12 No. 1 (2021)
- Sofía Valle-Olsen, Rafael Cabanás-Vega, Óscar Emilio Cazorla-Ramos, Jose Pérez-Arcos, Subglotic Stenosis as manifestation in Wegener’s Disease. A case report , Revista ORL: Vol. 8 No. 1 (2017)
- Dolores Rodríguez-Rodríguez, Cristina Isabel Sanz-Sánchez, Óscar Emilio Cazorla-Ramos, Necrotizing fascitis of the neck managenment with vacuum assisted therapy (VAC). Systematic review , Revista ORL: Online Continuous Publication
- Dolores Rodríguez-Rodríguez, Cristina Isabel Sanz-Sánchez, Óscar Emilio Cazorla-Ramos, Cervical necrotizing fascitis of odontogenous origin. A case report , Revista ORL: Online Continuous Publication
Downloads
Download data is not yet available.
+
−