Role of Montgomery salivary stent placement during pharyngolaryngectomy, to prevent pharyngocutaneous fistula in high-risk patients.

Abstract

OBJECTIVE:

To evaluate the incidence of pharyngocutaneous fistula after pharyngolaryngectomy with and without a Montgomery salivary stent.

DESIGN:

Retrospective analysis of patients with factors that predispose to the development of pharyngocutaneous fistula (i.e. disease extending to the supraglottic region, base of the tongue or pyriform sinuses, and/or radiochemotherapy).

SUBJECTS:

Between 2002 and 2008, 85 pharyngolaryngectomies were performed in our clinic. Of these patients, 31 were at increased risk of fistula development, of whom 45 per cent developed fistulas post-operatively. This subgroup of 31 patients was compared with a second subgroup of 22 patients at high risk of fistula development, treated between 2009 and 2011 with pharyngolaryngectomy and with a Montgomery salivary stent placed in advance during closure of the neopharynx.

RESULTS:

Statistical analysis showed a significant reduction in the rate of fistula development, from 45 to 9 per cent (p < 0.01), with application of the salivary stent.

CONCLUSION:

These data confirm the preventive effect of a salivary stent placed during pharyngolaryngectomy, for patients at high risk of fistula development.

• Authors: S Bondi, L Giordano, P Limardo, M Bussi
• Journal: The Journal of laryngology and otology (J Laryngol Otol) Vol. 127 Issue 1 Pg. 54-7 (Jan 2013) ISSN: 1748-5460 [Electronic] England
• PMID: 23164139 (Publication Type: Comparative Study, Journal Article)

Topics

• Cutaneous Fistula (epidemiology, etiology, prevention & control)
• Female
• Fistula (epidemiology, etiology, prevention & control)
• Follow-Up Studies
• Humans
• Incidence
• Italy (epidemiology)
• Laryngeal Neoplasms (complications, diagnosis, surgery)
• Laryngectomy (methods)
• Male
• Middle Aged
• Neoplasm Staging
• Pharyngectomy (methods)
• Postoperative Complications (epidemiology, etiology, prevention & control)
• Retrospective Studies
• Risk Factors
• Salivary Glands (surgery)
• Stents
• Tomography, X-Ray Computed