Pharyngocutaneous fistula after laryngeal surgery: The role of the barium swallow

A. M. Giordano, J. Cohen, G. L. Adams

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Abstract

Pharyngocutaneous fistula is one of the major complications following laryngeal surgery. Prior to 1979, patients undergoing laryngectomy at the University of Minnesota were not fed until 9 or 10 days postoperatively if unirradiated and 12 to 14 days if irradiated. Most fistulas were apparent by 14 days postoperatively, but occasionally a patient would develop a fistula as late as a month postoperatively. Starting in 1979, in an attempt to decrease the length of hospitalization as well as prevent fistula formation, routine barium-swallow videoesophagograms were obtained 7 days postoperatively in all laryngectomy patients. If the results were considered normal, the nasogastric tube was removed and oral feedings were started. Of a total of 45 patients undergoing wide-field laryngectomy, there were 3 clinical fistulas and 3 radiologic fistulas. Following this protocol, we shortened the average postoperative hospitalization by 2 days without an increase in the rate of fistulization.

Original languageEnglish (US)
Pages (from-to)19-23
Number of pages5
JournalOtolaryngology - Head and Neck Surgery
Volume92
Issue number1
DOIs
StatePublished - Jan 1 1984

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ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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