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Causes and consequences of anterior pharyngeal pouch after total laryngectomy

Published online by Cambridge University Press:  08 February 2014

S Anderson ,
D Hogan  and
B Panizza
S Anderson*
Affiliation:
Institute of Surgery, Townsville Hospital, Australia
D Hogan
Affiliation:
ENT Department, Mater Hospital, Brisbane, Australia
B Panizza
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
*
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
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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.

Keywords

LaryngectomyFistulaLaryngeal NeoplasmSurgical Closure Technique
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue S2 , July 2014 , pp. S39 - S42
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

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

References

1White, HN, Golden, B, Sweeny, L, Carroll, WR, Magnuson, JS, Rosenthal, EL. Assessment and incidence of salivary leak following laryngectomy. Laryngoscope 2012;122:1796–9CrossRefGoogle ScholarPubMed
2Boyce, SE, Meyers, AD. Oral feeding after total laryngectomy. Head Neck 1989;11:269–73Google Scholar
3Aswani, J, Thandar, M, Otiti, J, Fagan, J. Early oral feeding following total laryngectomy. J Laryngol Otol 2008;123:333–8CrossRefGoogle ScholarPubMed
4Seven, H, Calis, AB, Turgut, S. A randomized controlled trial of early oral feeding in laryngectomized patients. Laryngoscope 2003;113:1076–9CrossRefGoogle ScholarPubMed
5Tysome, JR, Jeannon, JP, Simo, R. Hydrogen peroxide aids assessment of pharyngeal closure after laryngectomy. J Laryngol Otol 2010;124:204–5CrossRefGoogle ScholarPubMed
6Kirchner, JA, Scatliff, JH, Dey, Fl, Shedd, DP. The pharynx after laryngectomy – changes in its structure and function. Laryngoscope 1962;73:18–33Google Scholar
7Davis, RK, Vincent, ME, Shapshay, SM, Strong, MS. The anatomy and complications of “T” versus vertical closure of the hypopharynx after laryngectomy. Laryngoscope 1982;92:16–22Google Scholar
8Nayar, RC, Sharma, VP, Arora, MM. A study of the pharynx after laryngectomy. J Laryngol Otol 1984;98:807–10Google Scholar
9Hartley, C, Saeed, SR, Farrington, WT. Post-laryngectomy neopharyngeal diverticula. J Laryngol Otol 1994;108:479–83CrossRefGoogle Scholar
10D'Souza, FR, Phillipps, JJ, Gupta, D. Endoscopic stapling of post-laryngectomy neopharyngeal anterior diverticulum. J Laryngol Otol 2001;115:753–4Google ScholarPubMed
11Penning, RJ, Van den Hoogan, FJ, Marres, HA. Laser treatment of symptomatic anterior pharyngeal pouches after laryngectomy. Head Neck 1999;21:310–14Google Scholar
12Gacek, RR. Management of vallecular pseudodiverticulum. Ann Otol Rhinol Laryngol 1980;89:201–3CrossRefGoogle ScholarPubMed