How to prevent and treat pharyngocutaneous fistulas after laryngectomy Book Section
| Author: | Singh, B. |
| Editor: | Cernea, C. R. |
| Article/Chapter Title: | How to prevent and treat pharyngocutaneous fistulas after laryngectomy |
| Abstract: | Once considered the cornerstone for the management of advanced larynx cancer, laryngectomies are now reserved for large tumors with extralaryngeal extension or, more commonly, for salvage after failure of either radiation or chemoradiation treatment. Although the initial organ preservation trials allowed selection of patients for early salvage surgery, the current state of the art is to deliver chemotherapy concomitantly with radiation, which rarely allows for early detection of failures. The benefits from concomitant chemoradiation treatment are tempered by higher rates of short- and long-term treatment-related sequelae. This is particularly relevant in patients that fail to respond to this treatment approach, having to endure the adverse effects of treatment without any appreciable benefit. Salvage laryngeal surgery poses a complex problem for the head and neck surgeon. The tissue is less vascularized and often has a reduced healing capacity, increasing the risk of FF. Published results and our own experience suggest that the fistula rate is doubled in this setting, prompting changes in standard approaches to pharyngeal closure. |
| Keywords: | Head surgery; Neck surgery; head and neck neoplasms surgery |
| Book Title: | Pearls and Pitfalls in Head and Neck Surgery: Practical Tips to Minimize Complications. 1st ed |
| ISBN: | 978-3-8055-8425-8 |
| Publisher: | S. Karger AG |
| Publication Place: | Basel, Switzerland |
| Date Published: | 2008-01-01 |
| Start Page: | 90 |
| End Page: | 91 |
| Language: | English |
| PROVIDER: | manual |
| Notes: | Book Chapter: 4.10 |
MSK Authors
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239Singh
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