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A Novel and Simple Technique to Reduce the Rate of Pharyngocutaneous Fistula Formation Following a Total Laryngectomy - our Initial Results

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Abstract

Objective: Pharyngocutaneous fistula (PCF) is a common and often devastating complication of total laryngectomy. Patients undergoing a total laryngectomy need enhancement of the neopharynx to reduce the risk of PCF formation. Our study aimed to evaluate the formation of a PCF following a total laryngectomy in patients that underwent a modified closure technique of their neopharynx. This technique included the recruitment of a flap of the muscular division of the pretracheal fascia that invests the strap muscles as a protective blanket. We called this surgical technique the ‘curtain call’. Methods: We conducted a retrospective study for patients who underwent a total laryngectomy in our department between May 2022 and May 2023. Results: Twelve patients were identified. Our results demonstrated that the recruitment of this modified closure technique to cover the neopharynx resulted in a very low rate of postoperative PCF formation (8.3%). Conclusion: The ‘curtain call’ technique is an excellent method to support the neopharynx with extremely low rates of postoperative chronic dysphagia and with no evidence of impairing the development of esophageal speech. It could sometimes substitute much more time-consuming techniques like major pectoralis flap and supraclavicular flap.

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Funding

The authors received no financial support for this study’s research, authorship, and/or publication.

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Authors and Affiliations

  1. Department of Anatomy and Surgical Anatomy, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece

    Alexandros Poutoglidis, George K. Paraskevas, Nikolaos Lazaridis & Stavros Savvakis

  2. Department of Otorhinolaryngology-Head and Neck Surgery, ’G. Papanikolaou’ General Hospital, Leoforos Papanikolaou 57010, Thessaloniki, Greece

    Evropi Forozidou & Paraskevi Karamitsou

  3. Department of Otorhinolaryngology, School of Medicine, Democritus University of Thrace, Alexandroupolis, 69100, Greece

    Georgios Fyrmpas

  4. Department of Otorhinolaryngology-Head and Neck Surgery, University of Erlangen-Nürnberg, 91054, Erlangen, Germany

    Konstantinos Mantsopoulos

Authors
  1. Alexandros Poutoglidis
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  2. Evropi Forozidou
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  3. Georgios Fyrmpas
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  4. Konstantinos Mantsopoulos
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  5. George K. Paraskevas
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  6. Nikolaos Lazaridis
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  7. Stavros Savvakis
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  8. Paraskevi Karamitsou
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Correspondence to Paraskevi Karamitsou.

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Poutoglidis, A., Forozidou, E., Fyrmpas, G. et al. A Novel and Simple Technique to Reduce the Rate of Pharyngocutaneous Fistula Formation Following a Total Laryngectomy - our Initial Results. Indian J Otolaryngol Head Neck Surg 76, 997–1001 (2024). https://doi.org/10.1007/s12070-023-04343-7

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  • DOI: https://doi.org/10.1007/s12070-023-04343-7

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