IMPORTANCE: Stricture and fistula formation are two of the most common long-term complications of free flap reconstruction of hypopharyngeal defects. OBJECTIVE: To examine the effects of salivary bypass tubes (SBTs) on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects. DESIGN: Retrospective cohort study. SETTING: Academic tertiary care medical center. PARTICIPANTS: A total of 103 consecutive patients who underwent hypopharyngeal free flap reconstruction. INTERVENTION: Use of salivary bypass tube. MAIN OUTCOME MEASURE: Fistula and stricture formation. RESULTS: The overall fistula and stricture rates were 14.6% and 27.2%, respectively. Subgroup analysis revealed fistula rates of 7.4% in patients who received SBTs and 22.4% in those who did not (P = .048). However, no statistically significant difference between the two groups was shown with multivariate analysis. The unadjusted stricture rate was 30.6% without vs 24.1% with SBT placement (P = .51). CONCLUSIONS AND RELEVANCE: Univariate analysis showed that SBT placement significantly reduced the risk of fistula in this population. Larger multicenter studies are needed to further explore the benefits of SBT use in preventing fistula and stricture formation. LEVEL OF EVIDENCE: 3.
IMPORTANCE: Stricture and fistula formation are two of the most common long-term complications of free flap reconstruction of hypopharyngeal defects. OBJECTIVE: To examine the effects of salivary bypass tubes (SBTs) on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects. DESIGN: Retrospective cohort study. SETTING: Academic tertiary care medical center. PARTICIPANTS: A total of 103 consecutive patients who underwent hypopharyngeal free flap reconstruction. INTERVENTION: Use of salivary bypass tube. MAIN OUTCOME MEASURE: Fistula and stricture formation. RESULTS: The overall fistula and stricture rates were 14.6% and 27.2%, respectively. Subgroup analysis revealed fistula rates of 7.4% in patients who received SBTs and 22.4% in those who did not (P = .048). However, no statistically significant difference between the two groups was shown with multivariate analysis. The unadjusted stricture rate was 30.6% without vs 24.1% with SBT placement (P = .51). CONCLUSIONS AND RELEVANCE: Univariate analysis showed that SBT placement significantly reduced the risk of fistula in this population. Larger multicenter studies are needed to further explore the benefits of SBT use in preventing fistula and stricture formation. LEVEL OF EVIDENCE: 3.
Authors: Andrew J Rosko; Andrew C Birkeland; Emily Bellile; Kevin J Kovatch; Ashley L Miller; Craig C Jaffe; Andrew G Shuman; Steven B Chinn; Chaz L Stucken; Kelly M Malloy; Jeffrey S Moyer; Keith A Casper; Mark E P Prince; Carol R Bradford; Gregory T Wolf; Douglas B Chepeha; Matthew E Spector Journal: Ann Surg Oncol Date: 2017-12-20 Impact factor: 5.344
Authors: Stefan Grasl; Stefan Janik; Matthaeus Christoph Grasl; Bernhard Parschalk; Boban M Erovic; Georg Haymerle Journal: Eur Arch Otorhinolaryngol Date: 2019-12-17 Impact factor: 2.503