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Pharyngeal fistulas after total laryngectomy with and without tracheostoma plasty according to Herrmann

European Archives of Oto-Rhino-Laryngology volume 275, pages 1281–1287 (2018)Cite this article

Abstract

Purpose

Pharyngeal fistula (PF) is one of the most common complications after total laryngectomy (TL). The tracheostoma plasty technique according to Herrmann (TPH) represents an alternative surgical technique to shape the tracheostoma. The aim of this study was to determine whether the performance of a TPH affects the incidence of PF after TL. A secondary aim was to identify potential risk factors for the development of PF with regard to TPH.

Methods

Retrospective evaluation of records of 151 consecutive patients at two tertiary care centers with regard to the occurrence and risk factors of PF after TL with and without TPH.

Results

60 patients with TPH and 91 patients without TPH contributed to the results. The overall incidence of PF was 21.2% (32 out of 151). 23.3% (14 out of 60) of patients with TPH and 19.8% (18 of 91) of patients without TPH developed a PF (p = 0.91). Binary logistic regression analysis revealed significant influence of salvage surgery on the risk to develop PF (odds ratio = 2.9; 95% CI 1.16–7.23; p = 0.026). The occurrence of PF was not significantly influenced by any other investigated factors including performance of TPH.

Conclusions

Performance of TPH after TL does not increase the incidence of PF. Thus, TPH can be considered as a safe alternative surgical technique for the shaping of the tracheostoma following TL.

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Funding

No funding has been received for this study.

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Author notes

  1. Philipp Wolber and David Schwarz contributed equally to this work.

Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Cologne, 50924, Cologne, Germany

    Philipp Wolber, David Schwarz, Matthias Balk, Nicola Luckscheiter & Antoniu-Oreste Gostian

  2. Department of Otolaryngology, Staedt. Kliniken Neuss, Neuss, Germany

    Claudia Sommer

Authors
  1. Philipp Wolber
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  2. David Schwarz
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  3. Matthias Balk
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  4. Nicola Luckscheiter
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  6. Antoniu-Oreste Gostian
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All authors contributed substantially to the paper in conception, design and writing.

Corresponding author

Correspondence to Philipp Wolber.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments.

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Wolber, P., Schwarz, D., Balk, M. et al. Pharyngeal fistulas after total laryngectomy with and without tracheostoma plasty according to Herrmann. Eur Arch Otorhinolaryngol 275, 1281–1287 (2018). https://doi.org/10.1007/s00405-018-4948-x

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  • DOI: https://doi.org/10.1007/s00405-018-4948-x

Keywords

  • Total laryngectomy
  • Postoperative complications
  • Fistula
  • Risk factors
  • Tracheostomy