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Routine use of salivary bypass tubes in laryngectomy patients: systematic review

Published online by Cambridge University Press:  15 February 2018

Y Kamhieh ,
H Fox ,
E Hallett  and
S Berry
Y Kamhieh*
Affiliation:
ENT Department, Morriston Hospital, Swansea, Wales, UK
H Fox
Affiliation:
ENT Department, Freeman Hospital, Newcastle upon Tyne, UK
E Hallett
Affiliation:
ENT Department, University Hospital of Wales, Cardiff, Wales, UK
S Berry
Affiliation:
ENT Department, Royal Glamorgan Hospital, Llantrisant, Wales, UK
*
Address for correspondence: Ms Yasmine Kamhieh, ENT Department, Morriston Hospital, Swansea SA6 6NL, Wales, UK E-mail: [email protected]
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Abstract

Background:

Pharyngocutaneous fistula is a cause of significant morbidity following laryngectomy. Routine use of salivary bypass tubes during laryngectomy has been proposed to reduce the incidence of fistulae and neopharyngeal strictures.

Method:

Following a systematic search of Embase, Medline and Cochrane databases (1946 – current), included articles were assessed for bias according to the Cochrane Handbook for Systematic Reviews of Interventions.

Results:

Three case–control trials showed reduced pharyngocutaneous fistula rates with the use of salivary bypass tubes; six case series reported widely varied fistula rates. With regards to stricture rates, the largest case–control trial found no improvement with salivary bypass tube use. No fatal adverse events were observed among the 204 patients who received a salivary bypass tube.

Conclusion:

Low-level evidence suggests salivary bypass tubes may reduce the incidence of fistula in high-risk patient groups. A robust randomised controlled trial, or large, multicentre cohort studies, are needed to further examine this intervention.

Keywords

LaryngectomySalivaStentsCutaneous FistulaStrictureMorbidity
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 5 , May 2018 , pp. 380 - 384
Copyright
Copyright © JLO (1984) Limited 2018 

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Footnotes

Presented orally at the American Head & Neck Society Meeting, 16–20 July 2016, Seattle, Washington, USA, and as a poster at the Wales Otorhinolaryngology Association Meeting, 7 October 2016, Saundersfoot, Wales, UK.

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