Pharyngo-cutaneous fistulas after total laryngectomy: incidence, etiology and outcome analysis.

A retrospective study of 126 patients who underwent total laryngectomy during a 10-year period was carried out. The incidence of post-laryngectomy pharyngo-cutaneous fistula was 19%. Pre-operative radiotherapy appears to be a risk factor when surgery is performed within three months of completion of radiotherapy. Intra-operative blood transfusion is strongly associated with fistula development. Fistula formation has an important effect on patient morbidity and mortality post-operatively. It remains a relatively frequent complication following total laryngectomy and may be able to be reduced in incidence if surgery is delayed post radiotherapy and blood transfusion is avoided whenever possible.