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Pharyngocutaneous fistulas after total laryngectomy or pharyngolaryngectomy: Place of video‐fluoroscopic swallowing study
Author(s) -
Carsuzaa Florent,
Capitaine AnneLaure,
Ferrié JeanClaude,
Apert Vincent,
Tonnerre Denis,
Frasca Denis,
Dufour Xavier
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26429
Subject(s) - medicine , laryngectomy , swallowing , fistula , surgery , larynx
Background Specify place of video‐fluoroscopic swallowing study (VFS) in the decision of oral refeeding after total pharyngolaryngectomy. Methods At postoperative day 7, a blue dye testing was performed. If negative, a VFS was performed looking for a blind fistula. If this exam was negative, oral refeeding was started, but if a blind fistula was observed, cervical compression bandage was performed. Results In 186 patients, a VFS was performed for 142 patients with negative blue dye testing. It was negative for 98 patients (69%) and positive for 44 patients (31%) (blind fistula). Patients had a probability of 7.1% to have a secondary pharyngocutaneous fistula (PCF) if the VFS was negative, and 15.9% if it was positive. No risk factor for the development of a secondary PCF or a blind fistula emerged from our analysis. Conclusion VFS should be performed before any oral refeeding in all patients operated with a total pharyngolaryngectomy.