The effect of the early oral feeding after total laryngectomy on the development of the pharyngocutaneous fistulae

Abstract

Objectives:The time to begin oral feeding after total laryngectomy remains a subject of debate among head and neck surgeons. Widely accepted consideration about this subject is early feeding may facilitate the development of pharyngocutaneous fistulae.Methods:68 patients who had been totally laryngectomized between January 1, 1998 and December 31, 2002 in SSK Tepecik Training Hospital, ENT - Head and Neck Surgery Clinic were included in this study. Patients were divided into two groups as control and study. 36 patients who had been totally laryngectomized between January 1998 and June 2001 formed the control group, who were orally fed 7 to 10 days after total laryngectomy. 32 patients consisted the study group that underwent total laryngectomy between August 2001 and December 2002. The oral feeding of this group began between the 24th and 72nd postoperative hours (average 2.1 days).Results:The developmental and the predispositional factors of the fistulae were evaluated. Pharyngocutaneous fistulae ratio was found to be 9.4% for the early feeding group (24 to 72 hours) and 13.9% for the late feeding group (7 to 10 days). The mean time for fistula to be formed was considered to be 7 days for the early feeding group and 10 days for the late feeding group. Hospitalization period of the patients without fistulae after the operation was found to be 9 days for early feeding group and 11.5 days for the late feeding group.Conclusion:The difference between these two groups is not statistically significant (p>0.05).

Keywords

• pharyngocutaneous fistulae
• total laryngectomy
• early feeding
• fistuale.