Staffieri's procedure revisited

Our long-term experience with Staffieri's procedure in 42 patients is presented. Our results were evaluated regarding voice production, aspiration problems, and pharyngocutaneous fistula formation. Approximately 50% of the patients were successfully rehabilitated. Twenty-five percent of the patients did not use the neoglottis for speech production, mostly because of stenosis of the neoglottis. The remaining 25% had serious aspiration problems that needed treatment. It was striking that half of these patients initially benefitted from the Staffieri procedure and had no aspiration problems. These 42 patients were compared with a group of 43 patients who underwent conventional total laryngectomy in the same period. After total laryngectomy and Staffieri's procedure, greater than 35% of the patients had a pharyngocutaneous fistula, while after conventional total laryngectomy the fistula rate was less than 20%. The average postoperative stay in the hospital was longer in the Staffieri group. In the long run, the results of this surgical technique do not justify its further use, especially after previous radiotherapy.