Endoscopic observation of pharyngeal mucosal suture healing process after total laryngectomy: case series

Acta Otolaryngol. 2023 May;143(5):434-439. doi: 10.1080/00016489.2023.2203700. Epub 2023 Apr 27.


Background: Pharyngocutaneous fistula (PCF), a major complication of total laryngectomy, is caused by pharyngeal repair failure.

Objective: Assess the usefulness of endoscopic observation of the pharyngeal suture's healing process for the early detection of PCF development.

Methods: Pharyngeal mucosal sutures were endoscopically observed postoperatively in patients who underwent total laryngectomy with primary closure.

Results: Postoperatively, a white coat adhered to the pharyngeal mucosal suture of all patients. In most cases, the white coat gradually receded, which was considered to be a normal healing process. Thickening of the white coat and/or dehiscence of surgical wound were interpreted as 'poor healing conditions'. Three cases were judged to have developed poor healing conditions of the pharyngeal mucosal suture and one patient developed PCF. The other two patients did not develop PCF, possibly due to early detection of 'poor healing condition' and conservative approach, such as discontinuation of oral intake.

Conclusions: Postoperative poor healing conditions of the pharyngeal mucosal suture may be precursors to PCF development. Endoscopic observation enables early detection of these conditions and may enable the prevention of PCF.

Keywords: Pharyngocutaneous fistula; endoscopic observation; healing process; surgical complications; total laryngectomy.

MeSH terms

  • Cutaneous Fistula* / prevention & control
  • Humans
  • Laryngeal Neoplasms* / complications
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy / adverse effects
  • Pharyngeal Diseases* / prevention & control
  • Pharynx / surgery
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Sutures / adverse effects