%0 Journal Article
%T Horizontal pharyngeal closure during total laryngectomy reduces rates of pharyngocutaneous fistula.
%A Giotakis AI
%A Potamianos S
%A Zachou Z
%A Giotakis EI
%A Kyrodimos E
%J Eur Arch Otorhinolaryngol
%V 281
%N 6
%D 2024 Jun 29
%M 38551697
%F 3.236
%R 10.1007/s00405-024-08593-1
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.