Tracheocutaneous fistula as a complication of laryngotracheal separation surgery

To evaluate the relationship between the occurrence of tracheocutaneous fistula of the proximal tracheal stump regarding the indication (therapeutic or prophylactic) of laryngotracheal separation surgery (LTS) and regarding the presence of a current or previous tracheostomy when LTS was performed. Retrospective analysis of 66 patients submitted to LTS. The tracheocutaneous fistula occurred in 14 (21.2%) patients. Twelve (33.3%) of 36 patients whose indication was therapeutic and in two (6.7%) of 30 patients whose indication was prophylactic (p = 0.019). It occurred in 8 (57.1%) of 14 patients who had undergone tracheostomy prior to completion of LTS, while occurred in 6 (11.5%) patients who had not previously undergone tracheostomy (n = 52) (p = 0.0009). The incidence of tracheocutaneous fistula as a postoperative complication of laryngotracheal separation is high and occurs mainly in patients whose indication is therapeutic and for those with a current or previous tracheostomy. Despite the significant incidence, most of them closed spontaneously through the adoption of conservative therapy.