A Case of Multiple Pharyngocutaneous Fistulae Following Post-Operative Concurrent Chemoradiotherapy for Oropharyngeal Cancer

Abstract

Pharyngocutaneous fistula is a readily encountered complication that occurs after surgery for laryngopharyngeal cancer. The development of pharyngocutaneous fistula increases hospitalization, delays postoperative adjuvant treatment, and can lead to serious complications such as wound infection and carotid artery rupture. Transoral robotic surgery (TORS) is actively being performed as a standard procedure for surgery of pharyngeal and laryngeal cancers. Many reports verified that TORS is advantageous in terms of perioperative outcomes such as decreased hospitalization and reduced rate of postoperative complications, free flap reconstruction, and tracheostomy or gastrostomy tube dependence relative to open surgery. However, careful selection of patients is mandatory and there are some critical points to consider in optimal treatment outcomes. Recently, we experienced a 47-year-old patient with tonsillar cancer who underwent lateral oropharyngectomy by TORS and radical neck dissection. Unfortunately, multiple pharyngocutaneous fistulae occurred following postoperative concurrent chemoradiotherapy (CCRT). Multiple phrayngocutaneous fistulae following TORS and postoperative CCRT have not been reported in the literature. Therefore, we report this case with a brief discussion supported by a review of the relevant literature.