Skip to main content Accessibility help
×
Home

Prophylactic antibiotics and post laryngectomy pharyngocutaneous fistulae

  • N. Violaris (a1) and M. Bridger (a1)

Abstract

Pharyngo-cutaneous fistula following laryngectomy is a serious complication. The incidence worldwide varies from 7.6 to 50 per cent. The value of prophylactic antibiotics in preventing fistulae is well recognized but the type of antibiotics and the length of administration of the antibiotics is variable depending on the individual surgeon.

Below we present the Plymouth Head and Neck Unit experience where, in the last five years, 33 patients underwent laryngectomy (30 total, three vertical hemi-laryngectomies).The prophylactic antibiotics used in all patients was parenteral cefotaxime 1G or cefuroxime 750 mg, given at eight hours pre-operatively, with the premedication and at eight, 16 and 24 hours post-operatively. Only two patients developed pharyngo-cutaneous fistulae, both after total laryngectomy (six per cent of total). Three patients developed skin cellulitis and five patients developed chest infection which required further treatment with antibiotics.

Copyright

Corresponding author

MrM. W. M. Bridger F.R.C.S., Consultant ENT Surgeon, Plymouth General Hospital, Greenbank, Plymouth.

Footnotes

Hide All

Presented at Section of Laryngology, Royal Society of Medicine, London, May 1989.

Footnotes

References

Hide All
Baker, H. W. (1963) Surgical management of recurrent laryngeal cancer after irradiation. Cancer, 16: 774780.
Briant, T. D. R. (1975) Spontaneous pharyngeal fistula and wound infection following laryngectomy. Laryngoscope, 85: 829834.
Cummings, C. W., Johnson, J., Chung, C. K., Sagerman, R. (1977) Complications of laryngectomy and neck dissection following planned pre-operative radiotherapy. Annals of Otology, Rhinology and Laryngology, 86: 245750.
Cuschieri, A., Giles, G. R., Moossa, A. R. (1984) Acute surgical infections on antibiotic therapy. Essential Surgical practice p. 3948. John Wright and Sons (Printing) Ltd, Bristol.
Dedo, D. D., Alonso, W. A., Ogura, J. H. (1975). Incidence, predisposing factors and outcome of pharyngo-cutaneous fistulae complicating head and neck cancer surgery. Annals of Otology, Rhinology and Laryngology, 84: 833840.
DeJong, P. C., Struben, W. H. (1970) Pharyngeal fistula after laryngectomy. Journal of Laryngology and Otology, 84: 897903.
George, C. F. (1979) Antibacterial Chemotherapy, Topics in Clinical Pharmacology p. 172. Henry Kimpton, London.
Goldman, J. L. (1972) High dosage pre-operative radiation and surgery for carcinoma of the larynx and laryngopharynx. A 14 year programme. Laryngoscope, 82: 18691882.
Hendrick, J. W. (1964) Surgical treatment of larynx and hypopharynx. Cancer, 79: 269–87.
Horgan, E. C., Dedo, H. H. (1979). Prevention of major and minor fistulae after laryngectomy. Laryngoscope, 89: 250258.
Innes, A. J., Windle-Taylor, P. C., Harrison, D. F. N. (1980). The role of Metronidazole in the prevention of fistulae following total laryngectomy. Clinical Oncology, 6: 7177.
Joseph, D. L., Shumrick, D. L. (1973). Risks of Head and Neck surgery in previously irradiated patients. Archives of Otolaryngology, 97: 381384.
Kirchner, J. A., Scatliff, J. F. (1962) Disabilities resulting from healed salivary fistula. Archives of Otolaryngology, 75: 4654.
Lavelle, R. J., Maw, A. R. (1972). The aetiology of post-laryngectomy pharyngo-cutaneous fistulae. Journal of Laryngology and Otology, 86: 785793.
Lundgren, J., Olofsson, J. (1979) Pharyngo-cutaneous fistulae following total laryngectomy. Clinical Otolaryngology, 4: 1323.
Mendelsohn, M. S., Bridger, G. P. (1985). Pharyngo-cutaneous fistulae following laryngectomy. Australia and New Zealand Journal of Surgery, 55: 177179.
Ogura, J. (1951) Laryngectomy and radical neck dissection for carcinoma of larynx. Transactions of the American Academy of Ophthalmology and Otolaryngology, 56: 785808.
Riccabona, A. Von (1962) Wien: Jur frage der ertstehung und des verschlusses von pharynxfisteln. Archiv für ohren-, nasen and kehlkopfheilkunde. 180: 666669.
Shah, A. K., Ingle, M. V., Shah, K. C. (1985). Some thoughts on prevention of post-operative salivary fistula. Journal of postgraduate medicine. 31: 9597.
Weingrand, D. N., Spiro, R. H. (1983). Complications after laryngectomy. American journal of surgery, 146: 517520.

Prophylactic antibiotics and post laryngectomy pharyngocutaneous fistulae

  • N. Violaris (a1) and M. Bridger (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed