What are the predisposing risk factors for the development of a post-laryngectomy pharyngo-cutatneous fistula? How would you manage this complication?
Most common complication after laryngectomy (8-25%). Predisposing factors include, pharyngolaryngectomy, chronic CHF, postoperative Hgb level less than 12.5, patients who previously underwent trach, preoperative RT, diabetes, malnutrition. Majority close spontaneously (70%).