OBJECTIVES/HYPOTHESIS: Pharyngocutaneous fistulae (PCF) are known to occur in nearly one-third of patients after salvage total laryngectomy (STL). PCF has severe impact on duration of admission and costs and quality of life and can even cause severe complications such as bleeding, infection and death. Many patients need further surgical procedures. The implications for functional outcome and survival are less clear. Several studies have shown that using vascularized tissue from outside the radiation field reduces the risk of PCFs following STL. This review and meta-analysis aims to identify the evidence base to support this hypothesis. DATA SOURCES: English language literature from 2004 to 2013 REVIEW METHODS: We searched the English language literature for articles published on the subject from 2004 to 2013. RESULTS: Adequate data was available to identify pooled incidence rates from seven articles. The pooled relative risk derived from 591 patients was 0.63 (95% CI: 0.47 to 0.85), indicating that patients who have flap reconstruction/reinforcement reduced their risk of PCF by one-third. CONCLUSION: This pooled analysis suggests that there is a clear advantage in using vascularized tissue from outside the radiation field in the laryngectomy defect. While some studies show a clear reduction in PCF rates, others suggest that the fistulae that occur are smaller and rarely need repair.
OBJECTIVES/HYPOTHESIS: Pharyngocutaneous fistulae (PCF) are known to occur in nearly one-third of patients after salvage total laryngectomy (STL). PCF has severe impact on duration of admission and costs and quality of life and can even cause severe complications such as bleeding, infection and death. Many patients need further surgical procedures. The implications for functional outcome and survival are less clear. Several studies have shown that using vascularized tissue from outside the radiation field reduces the risk of PCFs following STL. This review and meta-analysis aims to identify the evidence base to support this hypothesis. DATA SOURCES: English language literature from 2004 to 2013 REVIEW METHODS: We searched the English language literature for articles published on the subject from 2004 to 2013. RESULTS: Adequate data was available to identify pooled incidence rates from seven articles. The pooled relative risk derived from 591 patients was 0.63 (95% CI: 0.47 to 0.85), indicating that patients who have flap reconstruction/reinforcement reduced their risk of PCF by one-third. CONCLUSION: This pooled analysis suggests that there is a clear advantage in using vascularized tissue from outside the radiation field in the laryngectomy defect. While some studies show a clear reduction in PCF rates, others suggest that the fistulae that occur are smaller and rarely need repair.
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: Magis Mandapathil; Marion Roessler; Jochen A Werner; Carl E Silver; Alessandra Rinaldo; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2014-04-23 Impact factor: 2.503
Authors: Vlad C Sandulache; Laura J Vandelaar; Heath D Skinner; Juan Cata; Katherine Hutcheson; Clifton David Fuller; Jack Phan; Zuhair Siddiqui; Stephen Y Lai; Randal S Weber; Mark E Zafereo Journal: Head Neck Date: 2016-02-16 Impact factor: 3.147
Authors: Diane W Chen; Tao Wang; Jonathan Shey-Sen Ni; Vlad C Sandulache; Evan M Graboyes; Mitchell Worley; Joshua D Hornig; Judith M Skoner; Terry A Day; Andrew T Huang Journal: Oral Oncol Date: 2019-03-28 Impact factor: 5.337
Authors: Eleni M Benson; Richard M Hirata; Carol B Thompson; Patrick K Ha; Carole Fakhry; John R Saunders; Joseph A Califano; Demetri Arnaoutakis; Marshall Levine; Mei Tang; Geoffrey Neuner; Barbara P Messing; Ray G F Blanco Journal: Am J Otolaryngol Date: 2014-09-02 Impact factor: 1.808