Pharyngo-jugular fistula after "salvage" total laryngectomy: A case report

Erika Crosetti, Andrea Fulcheri, Giovanni Succo

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: We present a rare case of pharyngo-jugular fistula in a patient who underwent salvage total laryngectomy after organ-sparing radiochemotherapy. Case presentation: A 77-year-old Caucasian man underwent total laryngectomy and bilateral neck dissection as salvage surgery after the failure of radiochemotherapy at another hospital. Thirty-five days after surgery, he was admitted to our emergency room for fever and massive oral bleeding during meals. Videopanendoscopy showed the presence of a large clot at the base of his tongue, while a neck computed tomography scan showed a pharyngo-jugular fistula with the presence of air in the left internal jugular vein. Cervicotomy was performed: the internal jugular vein was ligated and sectioned, and the pharyngeal defect was repaired with a pectoralis major myocutaneous flap. The postoperative period was uneventful. Twenty-five days post surgery, videofluorography showed the fistula had disappeared. Our patient then began oral feeding without complications and was discharged. At present, 5 years after the operation, our patient is alive and shows no evidence of disease. Conclusions: Pharyngo-jugular fistula is an uncommon complication after total laryngectomy, especially in the chemoradiation era, which is potentially fatal if not promptly treated.

Original languageEnglish
Article number226
JournalJournal of Medical Case Reports
Volume9
Issue number1
DOIs
Publication statusPublished - Oct 6 2015

Keywords

  • Complication after total laryngectomy
  • Fistula
  • Pharyngo-jugular fistula

ASJC Scopus subject areas

  • Medicine(all)

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