Treatment of pharyngeal fistula caused by laryngeal cancer complications

Pharyngeal fistula is a common complication after laryngeal cancer surgery, which is mainly related to factors such as preoperative preparation, intraoperative operation and nursing care of the patient. Patients with laryngeal cancer should know more about this and cooperate with medical staff to deal with it in time once it is found, so as not to aggravate the condition and affect recovery.

Currently, there are two methods for treating pharyngeal fistula: palliative therapy and surgical therapy. Regardless of the size of the pharyngeal fistula, there is no need to rush for surgical repair. If palliative therapy is ineffective, the fistula does not shrink and the surrounding area has become skin-derived, it is not too late to consider repair surgery.

Palliative care:

1. Systemic aspects: control infection, try to keep the fistula and the surrounding area dry and clean; strengthen the patient's nutritional support, eat more fresh vegetables and fruits, and avoid eating irritating and irritating foods; for patients with excessive fistula secretions, atropine preparations can be used under the guidance of a doctor to reduce the contamination of the fistula by secretions.

2. Local treatment: Strengthen dressing changes. If the fistula is small and uncontaminated, apply pressure bandage after dressing change and the wound will close on its own. If there is an infected fistula and sticky yellow-green secretions flow out, rinse with hydrogen peroxide, place iodoform gauze in the wound, and then bandage with sterile gauze to prevent further infection of the wound.

3. Time for using nasogastric feeding tube: Once a pharyngeal fistula is found in the patient, the removal of the nasogastric feeding tube should be delayed until the fistula heals. Patients with large pharyngeal fistula that does not heal can be discharged from the hospital with a nasogastric feeding tube and change the dressing by themselves.

Surgery

For patients whose fistulas do not heal well or even fail to heal after palliative treatment, and whose areas around the fistulas are mostly cortical, surgical repair should be considered. The most difficult fistulas to repair are large fistulas formed after laryngectomy after radiotherapy. Due to poor blood supply to the surrounding tissues, the transplanted tissues are not easy to grow together and fistulas may occur again.