[Complications of total laryngectomy in relation to the previous radiotherapy]

Different factors, particularly prior radiotherapy, are associated with the occurrence of postoperative complications after total laryngectomy. We compared the postoperative complications of 50 patients who underwent total laryngectomy without prior radiotherapy and those of 50 patients who underwent total laryngectomy for tumor recurrence or persistence after radiotherapy. Twenty-four percent of the patients without previous irradiation suffered cervical complications compared with 26% of the patients with previous irradiation. The most frequent cervical complication was pharyngo-cutaneous fistula, which occurred in 12% of the non-irradiated patients and in 18% of the irradiated patients. There were no significant differences in the frequency of complications or in the occurrence of fistulas in relation to prior radiotherapy. In the group of irradiated patients, the proportion of major fistulas was greater. The occurrence of cervical complications, particularly pharyngo-cutaneous fistulas, significantly prolonged the hospital stay.