Frequency and predisposing factors of pharyngocutaneous fistula after total laryngectomy

Objective: The objective of our study was to determine the frequency and predisposing factors of pharyngocutaneous fistula in postlaryngectomy patients. Materials and methods: Charts of those patients who were treated with total laryngectomy for laryngeal carcinoma in our department from 2000 to 2008 were reviewed. Total 77 patients were included in the study. The variables studied for the development of pharyngocutaneous fistula (PCF) after total laryngectomy were: age and gender, diabetes mellitus, post-operative hemoglobin, ischemic heart disease, chronic obstructive pulmonary disease, tumor characteristics including tumor site, stage, differentiation and extension into pyriform sinus, pre-operative radiotherapy, pre-operative chemotherapy, pre-operative tracheostomy and positive surgical margins. Results: Univariate analysis showed diabetes, pre-operative radiotherapy, pre-operative chemotherapy and pre-operative tracheostomy to be significantly associated with the formation of PCF. However, multivariate regression revealed that the only pre-operative radiotherapy was highly associated with the formation of PCF (OR = 132.923, P = 0.001). Conclusions: We found 28.6% incidence of pharyngocutaneous fistula mainly because of the number of patients undergoing radiotherapy and chemotherapy as primary treatment for laryngeal cancers is increasing with current approach of organ preservation protocol.