Alabdullah M, Shaker K, Alomar K, Sardini Z, Hamdan A, Yousef O. Management of pharyngocutaneous fistula following laryngectomy with autologous fat graft: A case report and literature review.
Int J Surg Case Rep 2024;
120:109781. [PMID:
38795412 PMCID:
PMC11143885 DOI:
10.1016/j.ijscr.2024.109781]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/14/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION AND SIGNIFICANCE
Pharyngocutaneous fistula (PCF) is a serious complication following total laryngectomy, significantly impacting patients' quality of life and treatment costs. Management is complex, with potential for recurrence after surgical intervention.
CASE PRESENTATION
We present a case of PCF that developed following laryngectomy. Initial conservative treatment failed to resolve the fistula. A pectoralis major myofascial flap was then attempted, but the fistula recurred. Finally, autologous fat grafting was performed with excellent results.
CLINICAL DISCUSSION
Conservative management should be the first-line approach for PCF, as most cases respond favorably. However, if the fistula persists, alternative methods should be explored to achieve optimal outcomes. Our case highlights the importance of not persisting with a failed approach. Autologous fat grafting offers a promising alternative with demonstrably positive outcomes.
CONCLUSION
Pharyngocutaneous fistula presents a significant challenge in post-laryngectomy care. Surgical repair can be complex with potential complications. Our case demonstrates the effectiveness of autologous fat grafting as a successful treatment modality.
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