Repair of oronasal fistula with silicone button in patients with head and neck cancer

Abstract

Until now, there is no optimal technique for repairing oronasal fistula in patients with prior head and neck radiotherapy and trismus. Use of the silicone button is a safe, office-based, and validated method in this situation. The indications of this procedure are also clarified in this study. This is a retrospective study of four patients who underwent a newly designed endoscopic repair of oronasal fistula with silicone button under local anesthesia from July 2012 to August 2012. Data on the size of the defect, length of operation, symptom relief, and post-operative complications were collected. Four patients underwent endoscopic repair of oronasal fistula with silicone button under local anesthesia. The diagnoses were benign palate lesion s/p operation, oral cancer s/p operation and radiotherapy. The defect diameter varied from 1 to 1.5 cm. The operation durations were between 20 and 30 min. In all cases, nasal regurgitation symptoms were relieved. The hypernasality of one case improved, while another had decreased nasal crusting and foul odors. No major complications were noted. There was a minor complication in one case, which exhibited frequent crusting around the silicone button. Silicon button can act as a temporary obturator to improve quality of life of patients. The indications for this procedure include patient undergone head and neck radiotherapy with (1) chronic fistula (>6 months); (2) small defect (1–2 cm); and (3) trismus.

Level of evidence: 4.