Acquired Non-malignant Cervical Trachea-Esophageal Fistula: A Case Series

Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):286-290. doi: 10.1007/s12070-018-1281-z. Epub 2018 Mar 13.

Abstract

Acquired non-malignant trachea-esophageal fistula (TEF) of cervical oesophagus is rare. Surgical closure of fistula is the standard treatment of choice. Our experience in management of such cases is presented. Five cases of acquired cervical TEF of varying etiology were retrospectively analysed. Two patients had history of migrated endoluminal stent. All the patients were treated by trans-cervical repair with muscle interposition. Tracheal Stenosis in two patients was managed concurrently. Successful repair was achieved in four cases. One patient with chronic obstructive pulmonary disease and active leprosy has residual fistula. Of the two patients with tracheal stenosis correction one was decannulated 6 month later and second has stent in situ. Post-operative vocal cord palsy occurred in one patient. Transcervical repair with muscle interposition is treatment of choice in cases of acquired nonmalignant cervical tracheoesophageal fistulas. Endoluminal stents have high tendency to migrate and are not recommended.

Keywords: Nonmalignant cervical tracheoesophageal fistula; Strap muscle flap; Tracheoesophageal fistula; Trans cervical repair.