Submental abscess: an unusual delayed complication of primary Blom-Singer valve insertion

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Surgical Complications

Background:

• Voice restoration after laryngectomy often utilizes the Blom-Singer prosthesis.
• This technique involves creating a tracheo-oesophageal fistula for prosthesis insertion.
• Potential complications include hemorrhage, perforation, cellulitis, and aspiration.

Observation:

• A previously unreported complication, a submental abscess, is described.
• This likely resulted from air forced through the fistula into unhealed tissue planes.
• Previous radiotherapy and aggressive phonation attempts exacerbated the condition.

Findings:

• The submental abscess developed in a patient post-laryngectomy and radiotherapy.
• The abscess formation was likely due to inadequate healing of the tracheo-oesophageal fistula.
• Over-zealous phonation efforts contributed to the complication.

Implications:

• Recommend a minimum six-week fistula maturation period post-radiotherapy before prosthesis insertion.
• Advise patients to practice relaxation techniques during voice rehabilitation.
• Highlights the importance of considering prior radiotherapy in fistula management and patient education.