Objectives: In this study, we aimed to determine and compare the pharyngocutaneous fistula (PCF) rates in patients undergoing primary total laryngectomy (TL) or those undergoing salvage TL following radiotherapy (RT)/chemoradiotherapy (CRT) failure.
Patients and methods: Between January 2006 and January 2012, medical records of 91 male patients (mean age 61.0+10.3 years; range 36 to 88 years) who underwent TL in our clinic were retrospectively reviewed.
Results: Total laryngectomies were performed in 64 patients primarily and 27 of the patients as salvage TL following RT or CRT. Intraoperative mortality was 1.1%. Pharyngocutaneous fistula rates were 14.3%, 25.9%, and 17.8% in primary surgery group in patients with salvage laryngectomy following RT/CRT, and all groups, respectively. This difference was not statistically significant (p>0.05). The mean of PCF beginning time in primary surgery and salvage surgery patients were 19.0 and 12.7 days respectively. The mean time to recovery was 31.6 in primary surgery group and 60.0 days in salvage surgery group. When the beginning time of the fistula and recovery time were compared, the difference was also not statistically significant (p>0.05).
Conclusion: Despite the lack of any statistically significant difference in our study, we found that post-TL PCF following RT/CRT occurs almost two times more frequently with earlier symptom onset and late recovery, compared to those undergoing primary surgery.