Abstract
Objective: To determine the viability of horizontal pharyngeal closure during total laryngectomies, as an alternative to vertical and T-closure methods, by evaluating the rates of pharyngocutaneous fistulas (PCFs) and dysphagia postoperatively.
Method: Retrospective analysis of postoperative complications associated with horizontal pharyngeal closure during total laryngectomies at a tertiary institution from 2007 to 2011. Chart reviews were performed on a total of 15 total laryngectomy patients with horizontal pharyngeal closure, evaluating for fistula formation and dysphagia compared to reported rates in the literature.
Results: Twenty percent (3/15) of patients developed postoperative PCFs, and 18% (2/11) with dysphagia. Patients that had not been tried on oral feeds due to wound complications or those with recurrent disease were excluded for evaluating dysphagia.
Conclusion: A literature search revealed no studies evaluating horizontal pharyngeal closure. Reported ranges of PCFs are 13% to 25%, with dysphagia 17% to 70%. This study shows PCFs and dysphagia rates within these ranges. Thus, horizontal pharyngeal closure appears to be a viable alternative to T and vertical closures.
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