After
laryngectomy or lateral pharyngotomy for treatment of laryngeal or
hypopharyngeal cancer the occurrence of a pharyngo-
cutaneous fistula is a challenging complication. Especially after previous
radiotherapy and expanded surgical resections of mucosa the management is demanding. Besides the prolonged
hospital stay, increased treatment costs and reduced quality of life, a delayed adjuvant treatment follows the development of a
fistula. Treatment strategies range from conservative procedures comprising
parenteral nutrition,
antibiotics and local
wound care to primary surgical closure or reconstructive tissue transfer. We report three cases of using the
fibrin/
thrombin-coated
collagen patch
TachoSil(®) as a solitary or adjuvant strategy in surgical treatment. In one patient primary closure of the
fistula was achieved by transoral application of the
collagen patch. In the other cases a not tension free primary
suture was strengthened by the adjuvant use of
TachoSil(®). The healing process was rapid and straightforward in all patients. The use of
TachoSil(®) may be indicated in between
conservative treatment strategies and reconstructive surgery. After occurrence of a
fistula the healing process is intended to be accelerated by primary closure with
TachoSil(®) or by sealing of a primary
suture.