Surgical repair of postlaryngectomy pharyngocutaneous fistulas

Pharyngo-cutaneous fistula is a common complication after laryngectomy, which increases both the morbidity and the hospital stay. The incidence rate varies from 8.7% to 24.8% in different institutions. The continuous salivary leak is very much troublesome for the patients. There are various predisposing factors out of which preoperative radiotherapy, diabetes, malnutrition is very important. Spontaneous closure occurs in most of the cases on conservative management and only a few need surgical closures. Surgical methods used are direct surgical repair in two layers inner mucosa and outer skin, single distant flap like DP or PMMC, double distant flap like DP and PMMC one for inner mucosa and another for outer skin. Post operative swallowing was satisfactory in all the cases and there was no recurrence of fistula in one and half year follow up.