Pharyngocutaneous fistulae are a common complication after total laryngectomy. Our study evaluates the correlation of postoperative radiographic swallowing studies and clinical symptoms. We also propose a grading system to classify leaks radiographically. The records of 45 patients who underwent total laryngectomy were retrospectively reviewed. All patients had a radiographic swallowing study (RSS) on or around the tenth postoperative day. A grading system was developed to classify radiographic findings (grade 0-5). Twenty-two patients had an abnormal RSS (grade 2-5). Three patients (13.6%) had clinical signs of impending fistula whereas radiography showed moderate leakage (grade 3) in one patient and a pharyngocutaneous fistula (grade 5) in two. The other 19 patients with radiographically demonstrated leakage had no clinical signs of anastomotic complications. After total laryngectomy, radiography may reveal anastomotic complications of varying severity. The grading system used in this study enabled us to objectively classify the radiological abnormalities on swallowing studies. Because most radiographic leakages were clinically silent and not all clinically apparent fistula were radiographically visible in our study, the role of routine postoperative radiographic swallowing studies in the absence of clinical signs or fistula remains unclear.

Author

R.F.D van la Parra, M Kon, P.P.A Schellekens, W.W Braunius and F.A Pameijer

Contact Details

Corresponding address:
M. Kon, M.D., Ph.D., University Medical Centre Utrecht, Department of Plastic, Reconstructive and Hand Surgery (G.04.122), PO Box 85500, 3508 GA Utrecht, The Netherlands

Reference

ICIS Cancer Imaging Volume 7 Issue 1
DOI: 10.1102/1470-7330.2007.0015

Date Posted

11 June 2007

Print PDF

Size

1.77 MB

Minimum Estimated Download Times

ADSL 2Mb/s (Broadband):	7 seconds
ADSL 512Kb/s (Broadband):	28 seconds
64 Kb/s (ISDN):	3 minutes 46 seconds
33.3 Kb/s (Typical Modem):	7 minutes 15 seconds

No part of this publication or site may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the Publisher, e-MED Limited, Permissions, PO Box 61053, London, SE16 7YZ. Tel: +44 (0)207 719 8989 Fax: +44 (0)560 126 4446, permissions@cancerimaging.org.