POSTLARYNGECTOMY PHARYNGOCUTANEOUS FISTULA - A STILL UNRESOLVED PROBLEM

Fifty-six total laryngectomy cases are presented with special referenc e to post-operative fistula formation. All these patients were operate d upon at the Department of Otorhinolaryngology at the Bnai Zion Medic al Centre by one surgeon over a 16-year period, from 1976-1992. The in cidence of fistula was 12.5 per cent. This paper could not verify repo rts that any specific factors were significantly related to fistula fo rmation, although there was a preponderance of fistulas in patients pr esenting with late stage tumours. No relationship was found with rate of infection, age, or between previous neck irradiation (ranging from 5500 to 7000 cGy) and fistula formation in the patient population. If a fistula occurs, the administration of oral solid food keeping the na sogastric tube in place for administration of fluids may lead to spont aneous closure of the fistula, with no need for secondary surgical rep air.