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Predictive Factors for the Occurrence of Pharyngostoma after Laryngectomy and Total Pharyngo-Laryngectomy in Yaounde and Douala

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第1期12卷 44-54页

作者： Andjock Nkouo Yves Christian Bola Siafa Antoine Meva’a Biouele Roger Christian kambou fohom armelle Ngono Ateba Gladys Mindja Eko David Njock Richard Djomou Francois Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon Anesthesiology and Reanimation Service Douala General Hospital Douala Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon

Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Multiple risk factors are known. The data from our environment concerning this condition are few. Thus, in order to contribute to the study of this complication in our environment, we proposed to carry out this study, whose objective was to determine the predictive factors for the occurrence of pharyngo-cutaneous fistula or pharyngostoma after total laryngectomy and total pharyngo-laryngectomy in Yaounde and Douala. Patients and Methods: This was a retrospective, cross-sectional, descriptive study conducted in the 5 Ear-Nose-Throat (ENT) department of hospital in the city of Yaounde and Douala. The study took place between January 2009 and December 2020. All patients who underwent total laryngectomy or total pharyngo-laryngectomy with a follow-up of at least one month were included in the study. Incomplete records were excluded, as well as those of patients who died before one month of postoperative follow-up. Results: We selected 48 cases of total laryngectomies (TL) and total pharyngo-laryngectomies (TPL), and identified 37 cases of pharyngostoma. 45 men (93.8%) and 3 women (6.3%). The mean age was 56.4 years with extremes ranging from 37 to 86 years. Smoking and alcoholism were noted in 75% and 79.2% of our patients respectively. A tracheotomy before TL and TPL was found in 41.7%. 100% of the tumours found were T3 or T4. The surgery was in 34 cases (70.8%) TL and in 14 cases (29.2%) TPL. Pharyngostomas were observed in 37 cases among 48 patients operated on, i.e. a frequency of 77.1%. The average delay of appearance was 7 to 14 days. We had spontaneous healing with pressure dressing and nasogastric tube feeding in 35 patients (77.8%) and two patients benefited from pectoralis major flap treatment;the healing time was 21 to 30 days. We did not find any co

关键词： Pharyngostoma Predictive Factors Yaounde and Douala

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