Document Type : Case Report
Department of Gastroenterology and Hepatology , Mashhad University of Medical Sciences, Mashhad, Iran.
Departments of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran.
Stem Cell and Regenerative Medicine Research Group, Department of Biochemistry, Stem Cell Laboratory, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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.
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.
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.