PHARYNGOCUTANEOUS FISTULAS IN LARYNGECTOMY PATIENTS - THE TORONTO HOSPITAL EXPERIENCE

Objective: The purpose of this study was to determine the rate of post -laryngectomy pharyngocutaneous fistulae and its association with age, gender, preoperative radiation, TNM staging, patients comorbidity fac tors, choice of ablation, choice of reconstruction, modality of postop erative feeding, and whether or not a primary tracheoesophageal punctu re was performed. Design: Retrospective clinical study. Setting: The T oronto Hospital/Princess Margaret Hospital, University of Toronto, Tor onto, Ontario. Method: One hundred and twenty-five consecutive larynge ctomy procedures performed between July 1, 1992, and October 1, 1996, were reviewed. Results: There was an overall fistula rate of 22%. No a ssociation found was between fistula rates and age, gender, patient co morbidity factors, TNM stage, choice of ablation, choice of reconstruc tion, modality of postoperative feeding, or whether a primary tracheoe sophageal puncture was performed or not. Conclusions: At this tertiary care head and neck oncology centre, pharyngocutaneous fistulae remain an unpredictable and serious complication with an estimated economic cost of Cdn $400,000 per pear.