Repair of Pharyngocutaneous Fistula (PCF) Using Montgomery Salivary bypass Tube after Salvage Total Laryngectomy following Failed Primary Radiotherapy: A Case Report

HM Teh, Mohd Sayuti R, Kahairi A, Bathma DS, Salman A, Nor Kamaruzaman Esa, Syaratul Emma Hashim

Abstract

The occurrence of pharyngocutaneous fistula (PCF) after total salvage laryngectomy following radiotherapy as primary treatment is quite common. In most cases, pharyngocutaneous fistula can heal spontaneously with conservative measures. Here, we are reporting a 69-year-old male with a residual carcinoma of the larynx following failed radiotherapy as primary treatment whose later underwent a salvage total laryngectomy. Post-operatively, it was complicated by the formation of pharyngocutaneous fistula which was failed to heal with conservative measures and few attempts of surgical repair. The fistula later healed with the application of Montgomery Salivarybypass tube after 3 weeks. The application of the salivary bypass tube should be considered and used to promote healing in persistent pharyngocutaneous fistula especially in a post radiotherapy patient.


Keywords: Pharyngocutaneous Fistula, Laryngectomy, Salivarybypass tube

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References

Sani A, Said H, Lokman S. Carcinoma of larynx in Malaysia. Med J Malaysia. 1992 Dec;47(4):297-302

Delgado IL, Ayora JR, Britez OA, Lopez IG, Guidaro TM, Yurrita BS.. Salvage surgery for locoregional recurrences of advanced pharyngolaryngeal squamous cell carcinoma after organ preservation failure. ActaOtorhinolaryngologicaItalica. 2014 Dec;34(6):382.

M. Javed Aslam , Zafar Ahmed , M. Azeem Aslam & Malik Iftikhar Ahmed. Complications of total laryngectomy. Pak J Med Sci January-March 2006 Vol. 22 No. 1 33-37

Hasan Z, Dwivedi RC, Gunaratne DA, Virk SA, Palme CE, Riffat F. Systematic review and meta-analysis of the complications of salvage total laryngectomy. European Journal of Surgical Oncology (EJSO). 2017 Jan 31;43(1):42-51.

Busoni M, Deganello A, Gallo O. Pharyngocutaneous fistula following total laryngectomy: analysis of risk factors, prognosis and treatment modalities. ActaOtorhinolaryngol Ital. 2015;35:400–405.

De Zinis LO, Ferrari L, Tomenzoli D, Premoli G, Parrinello G, Nicolai P. Post laryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy. Head & neck. 1999 Mar 1;21(2):131-8.

Saki N, Nikakhlagh S, Kazemi M. Pharyngocutaneous fistula after laryngectomy: incidence, predisposing factors, and outcome. Arch Iran Med. 2008 May 1;11(3):314-7.

Cecattoa Sb, Monteiro Soaresa M, Henriquesa T, Monteirob E, Ferreira Pinto Mourac CI. Predictivefactors for the postlaryngectomypharyngocutaneousfistula development: systematic review. Braz JOtorhinolaryngol. 2014;80(2):167-77.

PaydarfarJa, Birkmeyer NJ. Complications in head and neck surgery: a meta-analysis of postlaryngectomypharyngocutaneous fistula. Arch

Otolaryngol Head Neck Surg 2006; 132: 67-72.

Loaec E, Vaillant PY, Bonne L, Marianowski R. Negative-pressure wound therapy for the treatment of pharyngocutaneous fistula. European annals of

otorhinolaryngology, head and neck diseases. 2014

Dec 31;131(6):351-5.

Cavalot Andrea L, GervasioCf, Nazionale G, Albera R, Bussi M, Staffieri A, 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.

Bussu F, Gallus R, Navach V, et al. Contemporary role of pectoralis major regional flaps in head and neck surgery. Acta Otorhinolaryngologica Italica.

;34(5):327-341.

Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head & neck.

;34(4):580-588. doi:10.1002/hed.21712.

Cömert E, Tunçel Ü, Torun MT, et al. Pectoralis major myofascial flap in salvage laryngectomy. The Journal of Laryngology; Otology. 2014;128(8):714-719.

Rodrigo TJ, Llorente PJ, Suárez NC. Insertion of Montgomery salivary bypass tube under local anesthesia in patients with pharyngocutaneous

fistula following total laryngectomy. Actaotorrinolaringologicaespanola. 2004 May;55(5):244-6.

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