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Causes and consequences of anterior pharyngeal pouch after total laryngectomy

  • S Anderson (a1), D Hogan (a2) and B Panizza (a3)

Abstract

Objectives:

To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation.

Study design:

A prospective, observational study of 43 patients undergoing total laryngectomy.

Methods:

Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7–14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation.

Results:

The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation.

Conclusion:

The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.

Copyright

Corresponding author

Address for correspondence: Dr S Anderson, Institute of Surgery, Townsville Hospital, 100 Angus Smith Drive, Douglas, Qld, Australia4814 E-mail: shane_anderson@health.qld.gov.au

Footnotes

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Presented at the Australasian Society for Head and Neck Surgeons Annual Conference, 16–20 March 2013, Perth, Western Australia, Australia.

Footnotes

References

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