Abstract
Persistent tracheopharyngeal (TPF) and tracheo-oesophageal (TEF) fistulas after laryngectomy create a therapeutic challenge. The current classification of TPFs and TEFs is based on clinical experience without detailed anatomical information. In this study, casts of TPFs/TEFs were obtained from 16 patients; these were the first steps in manufacturing customised prostheses. Fistulas were classified according to the shape and dimension of the tracheopharyngeal and tracheo-oesophageal silicone casts and prostheses as well as on epithetic requirements. Four different types of fistulas were classified: Type A, a fistula with a straight axis between the neopharynx and oesophagus; Type B, a fistula with a stenosis of the neopharynx but a straight axis; Type C, the axis between the neopharynx and oesophagus is flexed anteriorly; and Type D, neighbouring structures are absent creating a large defect. This classification system might improve the manufacturing processes of customised prostheses in individual cases with challenging tracheopharyngeal and tracheo-oesophageal fistulas.
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There authors report no institutional or corporate affiliations or sources of funding that supported the work. The prostheses were manufactured by Ingo Greiner in the course of routine patient treatments as an individualised treatment approach.
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Herzog, M., Lorenz, K.J., Glien, A. et al. Treatment of tracheopharyngeal and tracheo-oesophageal fistulas following laryngectomy and fistula classification based on individual silicone casts. Eur Arch Otorhinolaryngol 272, 2961–2968 (2015). https://doi.org/10.1007/s00405-014-3246-5
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DOI: https://doi.org/10.1007/s00405-014-3246-5