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Updated: May 20, 2025
Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
The contrast swallow study: a sub-optimal investigation for identifying pharyngocutaneous fistula following
Henry Lonsdale1, Kristijonas Milinis1, Alexandra Bell1
1Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust Liverpool, UK.
Objectives:
This article aimed to evaluate the diagnostic accuracy of the contrast swallow study and its role in informing management decisions in patients following laryngectomy.
Methods:
A five-year retrospective case note review on all patients who underwent laryngectomy between April 2018 and July 2023 at a tertiary head and neck cancer centre.
Results:
A total of 82 patients met inclusion criteria; 22 had reported radiological evidence of a pharyngocutaneous fistula on contrast swallow study; of these only 1 developed a clinical pharyngocutaneous fistula. Of the 60 with no radiological evidence of a pharyngocutaneous fistula, 3 developed clinical pharyngocutaneous fistulas. This represents a positive predictive value of 5 per cent and a negative predictive value of 95 per cent.
Conclusion:
In this cohort, the contrast swallow study was a sub-optimal investigation. The high NPV may support decision-making when there is little clinical suspicion, however the low PPV represents significant over-reporting and may cloud the clinical decision-making process.
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