Abstract：
OBJECTIVE: Pharyngocutaneous fistula (PCF) is a possible complication following total laryngectomy (TL), with a mean incidence of 17%. We intended to investigate the effect of pharyngeal closure type during TL on the prevention of PCF.
METHODS: We retrospectively reviewed patients that underwent TL with a horizontal pharyngeal closure over a 10-year period. The frequency of PCF clinically, dysphagia, total oral diet, postoperative dilatation of the neopharynx and voice problems were tabulated.
RESULTS: Seventy-seven subjects underwent TL due to laryngeal tumor without pharyngeal extension. Of them, 45 underwent a salvage TL. PCF occurred in 1/77 subjects. The rest of the subjects (76/77) did not develop a PCF, neither in the early nor in the late postoperative phase. All subjects (15/77) that underwent implantation of a voice prosthesis were satisfied with their voice. No subject complained about dysphagia. Every subject achieved total oral diet.
CONCLUSIONS: The horizontal pharyngeal closure is a safe pharyngeal closure technique during TL, reduces PCF rates (< 2%), results in excellent voice rehabilitation and swallowing function, and can also be used during salvage TL instead of a major pectoral flap. This type of closure should be used only in selected patients with laryngeal disease without pharyngeal extension.
METHODS: We retrospectively reviewed patients that underwent TL with a horizontal pharyngeal closure over a 10-year period. The frequency of PCF clinically, dysphagia, total oral diet, postoperative dilatation of the neopharynx and voice problems were tabulated.
RESULTS: Seventy-seven subjects underwent TL due to laryngeal tumor without pharyngeal extension. Of them, 45 underwent a salvage TL. PCF occurred in 1/77 subjects. The rest of the subjects (76/77) did not develop a PCF, neither in the early nor in the late postoperative phase. All subjects (15/77) that underwent implantation of a voice prosthesis were satisfied with their voice. No subject complained about dysphagia. Every subject achieved total oral diet.
CONCLUSIONS: The horizontal pharyngeal closure is a safe pharyngeal closure technique during TL, reduces PCF rates (< 2%), results in excellent voice rehabilitation and swallowing function, and can also be used during salvage TL instead of a major pectoral flap. This type of closure should be used only in selected patients with laryngeal disease without pharyngeal extension.
摘要：
目的：咽部瘘（PCF）是全喉切除术（TL）后可能的并发症，平均发病率为17%。我们旨在研究TL期间咽部闭合类型对预防PCF的影响。
方法：我们回顾性分析了在10年期间接受TL水平咽部闭合的患者。PCF的临床频率，吞咽困难,总口服饮食，术后新咽部扩张和语音问题被列出。
结果：77名受试者因喉肿瘤而接受了无咽部延伸的TL治疗。其中,45人接受了打捞TL。1/77受试者发生PCF。其余的受试者（76/77）没有发展PCF，无论是在早期还是在术后后期。所有接受语音假体植入的受试者（15/77）对他们的声音感到满意。没有受试者抱怨吞咽困难。每个受试者都达到了总的口服饮食。
结论：在TL，降低PCF率(<2%)，结果良好的语音康复和吞咽功能，也可以在打捞TL期间使用，而不是主要的胸肌皮瓣。这种类型的闭合应仅用于某些没有咽部延伸的喉部疾病患者。
方法：我们回顾性分析了在10年期间接受TL水平咽部闭合的患者。PCF的临床频率，吞咽困难,总口服饮食，术后新咽部扩张和语音问题被列出。
结果：77名受试者因喉肿瘤而接受了无咽部延伸的TL治疗。其中,45人接受了打捞TL。1/77受试者发生PCF。其余的受试者（76/77）没有发展PCF，无论是在早期还是在术后后期。所有接受语音假体植入的受试者（15/77）对他们的声音感到满意。没有受试者抱怨吞咽困难。每个受试者都达到了总的口服饮食。
结论：在TL，降低PCF率(<2%)，结果良好的语音康复和吞咽功能，也可以在打捞TL期间使用，而不是主要的胸肌皮瓣。这种类型的闭合应仅用于某些没有咽部延伸的喉部疾病患者。
