Pharyngocutaneous fistula in irradiated patients: systematic review and our experience

J Laryngol Otol. 2022 Nov;136(11):1027-1033. doi: 10.1017/S0022215121004370. Epub 2022 Jan 7.

Abstract

Objective: Radiotherapy is considered a risk factor for pharyngocutaneous fistula after a total laryngectomy. This study aimed to analyse the impact of exclusive radiotherapy versus chemoradiotherapy and the time interval between radiotherapy and surgery on the risk of pharyngocutaneous fistula.

Method: This study was a retrospective revision of 171 patients treated with a total laryngectomy after radiotherapy or chemoradiotherapy.

Results: Pharyngocutaneous fistula occurred in 33 patients (19.3 per cent). Patients previously treated with chemoradiotherapy showed a non-significant higher pharyngocutaneous fistula rate compared with patients treated with radiotherapy (25.0 per cent vs 18.0 per cent; p = 0.455). Patients with a pharyngocutaneous fistula after chemoradiotherapy treatment required a surgical repair more frequently than patients treated with radiotherapy (p = 0.005). There were no significant differences in the pharyngocutaneous fistula rate depending on the time interval between radiotherapy and surgery (p = 0.580).

Conclusion: There were no differences in the pharyngocutaneous fistula rate after total laryngectomy depending on the previous treatment with radiotherapy or chemoradiotherapy, or depending on the interval between radiotherapy treatment and surgery.

Keywords: Chemoradiotherapy; Cutaneous Fistula; Laryngectomy; Radiotherapy.

Publication types

  • Systematic Review

MeSH terms

  • Cutaneous Fistula* / epidemiology
  • Cutaneous Fistula* / etiology
  • Humans
  • Laryngeal Neoplasms* / radiotherapy
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy / adverse effects
  • Pharyngeal Diseases* / epidemiology
  • Pharyngeal Diseases* / etiology
  • Pharyngeal Diseases* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies