Fibrin Glue in Postlaryngectomy Fistula-A Case Report

Document Type : Case Report

Authors

1 Department of Gastroenterology and Hepatology , Mashhad University of Medical Sciences, Mashhad, Iran.

2 Departments of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Stem Cell and Regenerative Medicine Research Group, Department of Biochemistry, Stem Cell Laboratory, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
One of the most common complications following total laryngectomy is pharyngocutaneous fistula (PCF). Various methods have been proposed to treat this disorder in recent studies, including a range of simple and conservative treatments to more aggressive therapies, such as various surgical procedures. One of the most innovative and least developed methods is the use of plasma-rich compounds, such as fibrin glue.
 
Case Report:
The patient was a 55-year-old woman with a transglottic squamous cell carcinoma of the T3N0M0 stage and PCF development following total laryngectomy surgery with total thyroidectomy and bilateral elective cervical lymph node dissection level I-IV. In spite of conservative treatment, the fistula was not recovered after 3 weeks. It was decided to perform fibrin glue injection into the fistula tract via the endoscopic approach. One month after the fibrin glue injection, no evidence of contrast extravasation was observed on barium swallow test, and the fistula was completely closed.
 
Conclusion:
No PCF has been treated with fibrin glue using only the endoscopic technique. The present study showed that fibrin glue can be used as an effective way to treat chronic fistulas in head and neck surgeries.

Keywords

References

  1. Sassler AM, Esclamado RM, Wolf GT. Surgery after organ preservation therapy. Analysis of wound complications. Arch Otolaryngol Head Neck Surg. 1995; 121(2):162–5.
  2. Cho BC, Kim M, Lee JH, Byun JS, Park JS, Baik BS. Pharyngoesophageal reconstruction with a tubed free radial forearm flap. J ReconstrMicrosurg. 1998; 14(8):535-40.
  3. Weber RS, Berkey BA, Forastiere A, Cooper J, Maor M, Goepfert H, et al. Outcome of salvage total laryngectomy following organ preservation therapy: the Radiation Therapy Oncology Group trial 91–11. Arch Otolaryngol Head Neck Surg. 2003; 129(1):44-9.
  4. Ganly I, Patel S, Matsuo J, Singh B, Kraus D, Boyle J. Postoperative complications of salvage total laryngectomy. Cancer. 2005; 103(10):2073–81.
  5. Sewnaik A, Keereweer S, Al-Mamgani A, et al. High complication risk of salvage surgery after chemoradiation failures. ActaOtolaryngol. 2012; 132(1):96–100.
  6. Paydarfar JA, Birkmeyer NJ. Complications in head and neck surgery: a meta-analysis of postlaryngectomypharyngocutaneous fistula. Arch Otolaryngol Head Neck Surg. 2006; 132(1):67–72.
  7. Tsou YA, Hua CH, Lin MH, Tseng HC, Tsai MH, Shaha A. Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer. Head Neck. 2010; 32(11):1494–500.
  8. Erdag MA, Arslanoglu S, Onal K, Songu M, Tuylu AO. Pharyngocutaneous fistula following total laryngectomy: multivariate analysis of risk factors. Eur Arch Otorhinolaryngol. 2013; 270(1):173–9.
  9. Hier M, Black MJ, Lafond G. Pharyngo-cutaneous fistulas after total laryngectomy: incidence, etiology and outcome analysis. J Otolaryngol. 1993; 22:164–6.
  10. Boscolo-Rizzo P, De Cillis G, Marchiori C, Carpene S, Da Mosto MC. Multivariate analysis of risk factors for pharyngocutaneous fistula after total laryngectomy. Eur Arch Otorhinolaryngol. 2008; 265:929–36.
  11. Galli J, De Corso E, Volante M, Almadori G, Paludetti G. Postlaryngectomypharyngocutaneous fistula: incidence, predisposing factors, and therapy. Otolaryngol Head Neck Surg. 2005; 133:689–94.
  12. White HN, Golden B, Sweeny L, Carroll WR, Magnuson JS, Rosenthal EL. Assessment and incidence of salivary leak following laryngectomy. Laryngoscope. 2012; 122:1796–9.
  13. Aarts MC, Rovers MM, Grau C, Grolman W, van der Heijden GJ. Salvage laryngectomy after primary radiotherapy: what are prognostic factors for the development of pharyngocutaneous fistulae? Otolaryngol Head Neck Surg. 2011; 144:5–9.
  14. Horgan EC, Dedo HH. Prevention of major and minor fistulae after laryngectomy. Laryngoscope. 1979; 89:250–60.
  15. Lavelle RJ, Maw AR. The aetiology of post-laryngectomy pharyngo-cutaneous fistulae. J Laryngol Otol. 1972; 86:785–93.
  16. Basheeth N, O'Leary G, Sheahan P. Pharyngocutaneous fistula after salvage laryngectomy: impact of interval between radiotherapy and surgery, and performance of bilateral neck dissection. Head Neck. 2013;36:580–4.
  17. Chee N, Siow JK. Pharyngocutaneous fistula after laryngectomy-incidence, predisposing factors and outcome.Singapore Med J.1999;40:
    130-2.
  18. Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC. Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence? Eur Arch Otorhinolaryngol. 2004; 261:61–7.
  19. Patel UA, Moore BA, Wax M, Rosenthal E, Sweeny L, Militsakh ON, et al. Impact of pharyngeal closure technique on fistula after salvage laryngectomy. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1156-62.
  20. Qureshi SS, Chaturvedi P, Pai PS, et al. A prospective study of pharyngocutaneous fistulas following total laryngectomy. J Cancer Res Ther. 2005; 1:51–6.
  21. Davis RK, Vincent ME, Shapshay SM, Strong MS. The anatomy and complications of “T” versus vertical closure of the hypopharynx after laryngectomy. Laryngoscope 92:16, 1982
  22. Cavalot AL, Gervasio CF, Nazionale G, Albera R, Bussi M, Staffieri A, et al. Pharyngocutaneous fistula as a complication of total laryngectomy: review of the literature and analysis of case records. Otolaryngol Head Neck Surg. 2000; 123(5):587–92.
  23. Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck. 2012; 34(4): 580–8.
  24. Paleri V, Drinnan M, van den Brekel MW, Hinni ML, Bradley PJ, Wolf GT, et al. Vascularised tissue to reduce fistula following salvage total laryngectomy: a systematic review. Laryngoscope. 2014; 124(8):1848–53.
  25. Bergel S: Uber Wirkungen des Fibrins. Dtsch Med Wochenschr 1909; 35(15): 663-5.
  26. Cronkite EP, Lozner EL, Deaver JM: Use of thrombin and fibrinogen in skin grafting. JAMA 1944; 124(14):976-8.
  27. Tedrick RT, Warner ED. Fibrin fixation of skin transplants. Surgery 1944; 15(1):90-95.
  28. McCarthy PM, Trastek VF, Schaff HV, Weiland LH, Bernatz PE, Payne WS, et al: Esophagogastric anastomoses: The value of fibrin glue in preventing leakage. J Thorac Cardiovasc Surg 1987; 93(2):234-9.
  29. Romeo G: Applications of tissucol in larynx, tracheaand neck surgery. Rev LaryngolOtol Rhinol (Bord) 1989;110(1):121-2.
  30. Saclarides TJ, Woodard DO, Bapna M, Economou SG. Fibringlue improves the healing of irradiated bowel anastomoses. Dis Colon Rectum 1992;35(3):249-52.
  31. Wiseman NE: Endoscopic closure of recurrent tracheoesophagealfistula using Tisseel. J PediatrSurg 1995;30(8):1236-7.
  32. Ussia G, Cuccomarino S, Ravo B, Galletti G. Combined laparoendoscopic colon resection and anastomosis usingthe “no touch technique” and fibrin glue. An experimentalstudy. SurgEndosc 1998; 12(8): 1046-50.
  33. Scappaticci E, Ardissone F, Ruffini E, Baldi S, Revello F, Coni F.As originally published in 1994: Postoperative bronchopleural fistula: Endoscopic closure in 12 patients. Updated in2000. Ann ThoracSurg 2000; 69(5):1629-30.
  34. Kacker A, Huo J: Reinforcement of an end-to-endtracheal resection anastomosis with fibrin
    glue: A casereport. Ear Nose Throat J 2001;80(4):
    234-6, 238.
  35. Sentovich SM: Fibrin glue for all anal fistulas. J GastrointestSurg 2001;5(2):158-61.
  36. Wiseman S, Hicks W, LoreeTh, Al-kasspooles M, Rigual N. Fibrin Glue–Reinforced Closure of PostlaryngectomyPharyngocutaneous Fistula. Am J Otolaryngol 2002;23(6):368-73.

 

 

 

Iranian Journal of Otorhinolaryngology
Volume 32, Issue 2
March and April 2020
Pages 113-119

Files

Share

How to cite

Statistics