Related Experiment Video
Updated: Jun 4, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation
Published on: August 2, 2024
Pharyngocutaneous fistula after total laryngectomy: Prevalence and risk factors
Petronella Pettersson1,2, Rasmus Blomkvist1,3, Krzysztof Piersiala1,2
1Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Objective:
To determine the prevalence and identify associated risk factors of pharyngocutaneous fistula following total laryngectomy.
Methods:
Medical records of 160 patients diagnosed with laryngeal cancer between 2000-2021, subsequently undergoing total laryngectomy at Karolinska University Hospital, were analyzed for demographics, comorbidities, tumor characteristics, treatments and postoperative outcomes. Uni- and multivariate analyses were used to identify risk factors for pharyngocutaneous fistula.
Results:
Pharyngocutaneous fistula developed in 28 patients (17.5%). Univariate analysis identified cardiovascular disease (OR 2.50; 95% CI 1.00-6.28), preoperative hemoglobin <110 g/L (OR 5.34; 95% CI 1.74-16.45), prior radiotherapy (OR 3.78; 95% CI 1.24-11.52), preoperative tracheostomy (OR 2.44; 95% CI 1.05-5.72), pharyngectomy (OR 8.47; 95% CI 2.46-29.17), neck dissection (OR 2.52; 95% CI 1.06-6.00), pectoral flap reconstruction (OR 10.83; 95% CI 1.88-62.49) and postoperative infection (OR 28.44; 95% CI 9.00-89.81) as significant risk factors. In multivariate analysis only pharyngectomy (OR 7.18; 95% CI 1.08-47.63; p = 0.041) and postoperative infection (OR 24.94; 95% CI 6.66-93.46; p < 0.001) remained independent.
Conclusions:
Pharyngocutaneous fistula is a common complication occurring in 17.5% of patients following total laryngectomy. Pharyngectomy and postoperative infection are independent risk factors for fistula formation.
Related Concept Videos
Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes: