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Role of Montgomery salivary stent placement during pharyngolaryngectomy, to prevent pharyngocutaneous fistula in high-risk patients

Published online by Cambridge University Press:  20 November 2012

S Bondi ,
L Giordano ,
P Limardo  and
M Bussi
S Bondi*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, S Raffaele Hospital, Vita-Salute University, Milan, Italy
L Giordano
Affiliation:
Department of Otolaryngology Head and Neck Surgery, S Raffaele Hospital, Vita-Salute University, Milan, Italy
P Limardo
Affiliation:
Department of Otolaryngology Head and Neck Surgery, S Raffaele Hospital, Vita-Salute University, Milan, Italy
M Bussi
Affiliation:
Department of Otolaryngology Head and Neck Surgery, S Raffaele Hospital, Vita-Salute University, Milan, Italy
*
Address for correspondence: Dr Stefano Bondi, Via Olgettina 60, 20132 Milan, Italy Fax: +39 0226433508 E-mail: bondi.stefano@hsr.it
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Abstract

Objective:

To evaluate the incidence of pharyngocutaneous fistula after pharyngolaryngectomy with and without a Montgomery salivary stent.

Design:

Retrospective analysis of patients with factors that predispose to the development of pharyngocutaneous fistula (i.e. disease extending to the supraglottic region, base of the tongue or pyriform sinuses, and/or radiochemotherapy).

Subjects:

Between 2002 and 2008, 85 pharyngolaryngectomies were performed in our clinic. Of these patients, 31 were at increased risk of fistula development, of whom 45 per cent developed fistulas post-operatively. This subgroup of 31 patients was compared with a second subgroup of 22 patients at high risk of fistula development, treated between 2009 and 2011 with pharyngolaryngectomy and with a Montgomery salivary stent placed in advance during closure of the neopharynx.

Results:

Statistical analysis showed a significant reduction in the rate of fistula development, from 45 to 9 per cent (p < 0.01), with application of the salivary stent.

Conclusion:

These data confirm the preventive effect of a salivary stent placed during pharyngolaryngectomy, for patients at high risk of fistula development.

Keywords

PharynxFistulaLaryngeal NeoplasmsPharyngectomyLaryngectomyStent
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 54 - 57
Copyright
Copyright © JLO (1984) Limited 2012

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