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Digestive Disease Interventions 2021; 05(04): 319-323
DOI: 10.1055/s-0041-1735319
Review Article

The Novel Use of Flexible Endoscopic Techniques in the Management of Pharyngocutaneous Fistulas

Shivam Patel
1   College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania
,
Colin G. DeLong
2   Department of General Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
,
Luis De Jesus Sanchez
2   Department of General Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
,
Neerav Goyal
3   Division of Head and Neck Surgery, Department of Otolaryngology – Head and Neck Surgery, Neurosurgery, and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
,
Eric M. Pauli
4   Division of Minimally and Invasive and Bariatric Surgery, Department of Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Abstract

Pharyngocutaneous fistula (PCF) is a complication of laryngectomies in 14 to 23% of patients. The rate of spontaneous resolution of small and low-output fistulas has been shown to be 65 to 94% in those who are radiation-naive, with a reduced rate of resolution in patients who were previously radiated as low as 33%. Two patients are presented who underwent total laryngopharyngectomy and anterolateral thigh free flap reconstruction at our institution eventually complicated with PCF. All the pertinent patient data were retrieved through chart review from the records of our institution. The cases presented had a prior history of radiation or chemoradiation complicating the spontaneous resolution of the PCF. Both patients had successful resolution of PCF with the flexible endoscopic techniques presented. This case series highlights the management of small PCFs using flexible endoscopic techniques including over-the-scope clips and Vicryl mesh plugs.

Keywords

pharyngocutaneous fistula - flexible endoscopy - total laryngectomy

Authors' Contribution

All authors had full access to the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.




Publikationsverlauf

Eingereicht: 17. November 2020

Angenommen: 01. März 2021

Artikel online veröffentlicht:
23. August 2021

© 2021. Thieme. All rights reserved.

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