Pharyngocutaneous fistulas after total laryngectomy or pharyngolaryngectomy: Place of video‐fluoroscopic swallowing study. Issue 12 (30th August 2020)

• Record Type: Journal Article
• Authors: Carsuzaa, Florent; Capitaine, Anne‐Laure; Ferrié, Jean‐Claude; Apert, Vincent; Tonnerre, Denis; Frasca, Denis; Dufour, Xavier
• Is Part Of: Head & neck. Volume 42:Issue 12(2020)
• Page Start: 3638
• Page End: 3646
• Publication Date: 2020-08-30
• Subjects: pharyngocutaneous fistula -- pharyngolarynx -- radiation -- squamous cell carcinoma -- video‐fluoroscopic swallowing study; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26429
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: 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.