Pharyngocutaneous fistula after total laryngectomy

Postoperative pharyngocutaneous fistula is a major complication of total laryngectomy that prolongs hospital stay and even thretens life. It is a common complication that increased the morbidity and mortality of the procedure. In the Department of Otorhinolaryngology of the Severance Hospital, 74 patients underwent total laryngectomy from January 1992 through December 1994. Nine patients developed fistula (incidence 12.2%). In the patients with preoperative radio therapy or pharyngeal reconstruction with forearm free flap showed the increased tendency to develop fistula. Other causes were thought to be postoperative hematoma, residual tumor, planned fistula and technical problem of repair. Seven of nine fistula were closed successfully with conservative or second surgical procedure. Average completion time was 48.7 day (range 22-93 days). Early diversion of the fistula was effective to shorten the hospital stay and to protect from aspiration.ope