Management of Pharyngocutaneous fistula with total laryngectomy

Abstract

Leakage and pharyngocutaneous fistula are among the most troublesome postoperative complications after total laryngectomy and require an unexpectedly long hospital stay for patients. Although surgical closure is the most common treatment for pharyngocutaneous fistula, frequent dressing and complicated management are necessary. We report here the introduction of negative pressure wound therapy (NPWT) to manage the fistula wound of patients after total laryngectomy and a pharyngocutaneous drainage method using a tracheal opening retainer. These approaches avoid contamination by saliva around the wound, and reduce the frequency of dressing (every two days). This method could be effective for patients and medical staff, reducing both stressful procedures and time.