Table 4 Details of fistula patients
From: Role of blue dye test as an early predictor of post-laryngectomy pharyngocutaneous fistula
No | Diagnosis | Intervention | Risk factor | Comorbidities | Time of identification | Fistula management | Outcome |
|---|---|---|---|---|---|---|---|
1 | Persistent transglottic SCC/post chemo/XRT | Salvage total laryngectomy, Rt SND, Supraclavicular flap | Smoking | None | POD 34 | Conservative | Clinical resolution with blue dye test at POD 54, gastrostomy dependent then total oral |
2 | Chondroradionecrosis post transglottic SCC/post chemo/XRT | Salvage total laryngectomy, Rt SND, & Primary closure | Smoking | Hypothyroidism | POD 12 | Surgical debridement and closure | Radiographic resolution of fistula with barium swallow at POD 38, gastrostomy dependent then total oral feeding |
3 | Transglottic SCC T4a | Primary laryngectomy, BCND, PMMC flap | Smoking | None | POD 10 | Conservative | Clinical resolution with blue dye test at POD 17 then confirmed by radiological resolution of fistula with barium swallow at POD 19, then the patient resumes full oral intake |
4 | Recurrent transglottic SCC/post chemo/XRT | Salvage total laryngectomy, BSND, primary closure | Smoking | None | POD 12 | Surgical debridement and closure, then later dehiscence managed conservative | Clinical resolution with repeated blue dye test at POD 41, 54, and 70 with complete cure and resume full oral intake |
5 | Recurrent transglottic SCC/post chemo/XRT | Salvage total laryngectomy, BSND, primary closure | Smoking | None | POD 5 | Conservative | Clinical resolution with repeated blue dye test at POD 16 and 23 with complete cure and resume full oral intake |
6 | Transglottic SCC T4a | Primary laryngectomy, RT MRND, LT SND, primary closure | Smoker | Hypothyroidism | POD 11 | Conservative | Clinical resolution with blue dye test at POD 21 then confirmed by radiological resolution with barium swallow at POD 22 |
7 | Recurrent transglottic SCC T4a/ post chemo/ XRT | Salvage total laryngectomy, primary closure | Smoker | None | POD 6 | Conservative | Radiological resolution of fistula with barium swallow at POD 30 then resume oral intake |