Effects of Salivary Bypass Tubes on Fistula and Stricture Formation

Abstract

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.

Punthakee et al examined the effects of salivary bypass tubes on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects.