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Radiotherapy and complications of laryngectomy

Published online by Cambridge University Press:  29 June 2007

A. W. McCombe  and
A. S. Jones
A. W. McCombe
Affiliation:
(Liverpool)
A. S. Jones*
Affiliation:
(Liverpool)
*
Mr. A.S. Jones, M.D., F.R.C.S., Department of Otolaryngology, University of Liverpool, PO Box 147, Liverpool L69 3BX.
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Abstract

In an effort to establish factors responsible for our post laryngectomy fistulae we reviewed 357 patients who underwent total laryngectomy between 1965 and 1990, for laryngeal carcinoma. Pharyngocutaneous fistulae occurred in 84 cases (23 percent). There was no difference between the fistula group and the non-fistula group with regard to age, sex, general condition, or tumour differentiation. The only significant, positive association was with previous radical radiotherapy (10 fistulae out of 167 primary laryngectomies (4 percent) versus 74 fistulae out of 190 salvage laryngectomies (39 percent)). The median time to occurrence of a fistula was day seven in both groups. However, in the non-radiotherapy group the median duration of the fistula was 28 days; the majority healing spontaneously, with only one patient requiring surgical closure. There were no ‘hospital’ deaths. In the radiotherapy group the median duration of fistulae was 112 days with 30 patients requiring a total of 66 procedures to achieve closure of the fistula. There were six ‘hospital’ deaths in this group.

We conclude that previous radical radiotherapy strongly predisposes towards the occurrence of a postlaryngectomy fistula. Fistulae in this group tend to be longer lasting and are more likely to require surgical repair.

Keywords

LaryngectomycomplicationsRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 2 , February 1993 , pp. 130 - 132
Copyright
Copyright © JLO (1984) Limited 1993

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References

AJC(1990) Manual for staging cancer, 3rd edition (Bearhs, O. H., Henson, D. E., Hutter, R. V. P., Myers, M. H., eds.) J. B. Lipincott, New York.Google Scholar
Boyce, S. E., Myers, A. D. (1989) Oral feeding after total laryngectomy. Head and Neck Surgery, 11: 269–273.Google Scholar
Bresson, K., Rasmusson, H., Rasmussan, P. A. (1974) Pharyngocutaneous fistulae in totally laryngectomized patients. Journal of Laryngology and Otology, 88: 835–842.Google Scholar
Dedo, H. H., Alonso, W. A., Ogura, J. H. (1975) Incidence, predisposing factors and outcome of pharyngocutaneous fistulas complications head and neck cancer surgery. Annals of Otology, 84: 833–840.Google ScholarPubMed
Gullans, P. J., Jabbour, J. M., Conley, J. J. et al. (1979) Correlation of pharyngeal fistulization with pre-operative radiotherapy, reduced serum albumin and dietary obstruction. Otolaryngology—Head and Neck Surgery, 87: 311–317.Google Scholar
Hendrick, J. W. (1964) Surgical treatment of larynx and hypopharynx cancer. Archives of Otolaryngology, 79: 269–287.CrossRefGoogle ScholarPubMed
Lavelle, R. J., Maw, A. R. (1972) The aetiology of post-laryngectomy pharyngo-cutaneous fistulae. Journal of Laryngology and Otology, 86: 785–793.CrossRefGoogle ScholarPubMed
Lundgren, J., Olofsson, J. (1979) Pharyngocutaneous fistulae following total laryngectomy. Clinical Otolaryngology, 4: 13–23.Google Scholar
Mantravadi, R. V. P., Skolnik, E. M., Applebaum, E. L. (1981) Complications of post-operative and pre-operative radiation therapy in head and neck cancers. Archives of Otolaryngology, 107: 690–693.CrossRefGoogle Scholar
Maw, A. R., Lavelle, R. J. (1972) The management of post-operative pharyngo-cutaneous fistulae. Journal of Laryngology and Otology, 86; 795–805.CrossRefGoogle Scholar
SAS Institute Inc. (1985) SAS User's Guide: Statistics, Version 5th Edition. SAS institute Inc. Cary, North Carolina.Google Scholar
Stell, P. M., Cooney, T. C. (1974) Management of fistulae of the head and neck after radical surgery. Journal of Laryngology and Otology, 88: 819–833.Google Scholar
Stell, P. M., Maran, A. G. D. (1978) Head and Neck Surgery, 2nd Edition.Heinemann, London, p. 125–151 and p. 169–179.Google Scholar
UICC (1987) TNM classification of malignant tumours. (Hermanik, P., Sobin, L. H., eds.) Springer-Verlag, Berlin and London.Google Scholar
Walter, J. B., Israel, M. S. (1987) General Pathology, 6th Edition, Churchill Livingstone, Edinburgh and London, p. 434.Google Scholar
Weingrad, D. N., Spiro, R. H. (1983) Complications after laryngectomy. American Journal of Surgery, 146; 517–520.Google Scholar