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Prophylactic antibiotics and post laryngectomy pharyngocutaneous fistulae

Published online by Cambridge University Press:  29 June 2007

N. Violaris  and
M. Bridger
N. Violaris
Affiliation:
Plymouth
M. Bridger*
Affiliation:
Plymouth
*
MrM. W. M. Bridger F.R.C.S., Consultant ENT Surgeon, Plymouth General Hospital, Greenbank, Plymouth.
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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.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 104 , Issue 3 , March 1990 , pp. 225 - 228
Copyright
Copyright © JLO (1984) Limited 1990

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Footnotes

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

References

Baker, H. W. (1963) Surgical management of recurrent laryngeal cancer after irradiation. Cancer, 16: 774–780.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Briant, T. D. R. (1975) Spontaneous pharyngeal fistula and wound infection following laryngectomy. Laryngoscope, 85: 829–834.CrossRefGoogle ScholarPubMed
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: 245–750.CrossRefGoogle Scholar
Cuschieri, A., Giles, G. R., Moossa, A. R. (1984) Acute surgical infections on antibiotic therapy. Essential Surgical practice p. 39–48. John Wright and Sons (Printing) Ltd, Bristol.Google Scholar
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: 833–840.CrossRefGoogle Scholar
DeJong, P. C., Struben, W. H. (1970) Pharyngeal fistula after laryngectomy. Journal of Laryngology and Otology, 84: 897–903.CrossRefGoogle Scholar
George, C. F. (1979) Antibacterial Chemotherapy, Topics in Clinical Pharmacology p. 172. Henry Kimpton, London.Google Scholar
Goldman, J. L. (1972) High dosage pre-operative radiation and surgery for carcinoma of the larynx and laryngopharynx. A 14 year programme. Laryngoscope, 82: 1869–1882.CrossRefGoogle Scholar
Hendrick, J. W. (1964) Surgical treatment of larynx and hypopharynx. Cancer, 79: 269–87.Google ScholarPubMed
Horgan, E. C., Dedo, H. H. (1979). Prevention of major and minor fistulae after laryngectomy. Laryngoscope, 89: 250–258.CrossRefGoogle ScholarPubMed
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: 71–77.Google ScholarPubMed
Joseph, D. L., Shumrick, D. L. (1973). Risks of Head and Neck surgery in previously irradiated patients. Archives of Otolaryngology, 97: 381–384.CrossRefGoogle ScholarPubMed
Kirchner, J. A., Scatliff, J. F. (1962) Disabilities resulting from healed salivary fistula. Archives of Otolaryngology, 75: 46–54.CrossRefGoogle ScholarPubMed
Lavelle, R. J., Maw, A. R. (1972). The aetiology of post-laryngectomy pharyngo-cutaneous fistulae. Journal of Laryngology and Otology, 86: 785–793.CrossRefGoogle ScholarPubMed
Lundgren, J., Olofsson, J. (1979) Pharyngo-cutaneous fistulae following total laryngectomy. Clinical Otolaryngology, 4: 13–23.CrossRefGoogle Scholar
Mendelsohn, M. S., Bridger, G. P. (1985). Pharyngo-cutaneous fistulae following laryngectomy. Australia and New Zealand Journal of Surgery, 55: 177–179.CrossRefGoogle Scholar
Ogura, J. (1951) Laryngectomy and radical neck dissection for carcinoma of larynx. Transactions of the American Academy of Ophthalmology and Otolaryngology, 56: 785–808.Google Scholar
Riccabona, A. Von (1962) Wien: Jur frage der ertstehung und des verschlusses von pharynxfisteln. Archiv für ohren-, nasen and kehlkopfheilkunde. 180: 666–669.CrossRefGoogle Scholar
Shah, A. K., Ingle, M. V., Shah, K. C. (1985). Some thoughts on prevention of post-operative salivary fistula. Journal of postgraduate medicine. 31: 95–97.Google ScholarPubMed
Weingrand, D. N., Spiro, R. H. (1983). Complications after laryngectomy. American journal of surgery, 146: 517–520.CrossRefGoogle Scholar