Open AccessPharyngeal Horizontal Closure in Total Laryngectomies
Author(s) -
Clavenna Matthew,
Obokhare Joy,
Gill Matthew T.,
Lian Timothy S.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a148
Subject(s) - dysphagia , medicine , laryngectomy , surgery , closure (psychology) , pharynx , retrospective cohort study , fistula , otorhinolaryngology , larynx , market economy , economics
Objective To determine the viability of horizontal pharyngeal closure during total laryngectomies, as an alternative to vertical and T‐closure methods, by evaluating the rates of pharyngocutaneous fistulas (PCFs) and dysphagia postoperatively. Method Retrospective analysis of postoperative complications associated with horizontal pharyngeal closure during total laryngectomies at a tertiary institution from 2007 to 2011. Chart reviews were performed on a total of 15 total laryngectomy patients with horizontal pharyngeal closure, evaluating for fistula formation and dysphagia compared to reported rates in the literature. Results Twenty percent (3/15) of patients developed postoperative PCFs, and 18% (2/11) with dysphagia. Patients that had not been tried on oral feeds due to wound complications or those with recurrent disease were excluded for evaluating dysphagia. Conclusion A literature search revealed no studies evaluating horizontal pharyngeal closure. Reported ranges of PCFs are 13% to 25%, with dysphagia 17% to 70%. This study shows PCFs and dysphagia rates within these ranges. Thus, horizontal pharyngeal closure appears to be a viable alternative to T and vertical closures.