Plastic repair of pharyngeal fistulas.

Abstract

EXCISIONAL surgery for cancer of the larynx and pharynx has always been accompanied by the possibility of subsequent fistulas in the neck. In former years this ensuing complication was treated by delayed plastic reconstructive procedures in a secondstage operation, while directing the first operation primarily to the excision of the anatomical areas involved by the disease. The uncomfortable and handicapping postoperative condition of the patient, originating in feeding difficulties, constant drooling of saliva, etc, motivated the surgeons to look for a more satisfactory solution to this situation. As a result, in recent years primary reconstructive surgery in continuity with excisional surgery has been performed whenever possible, unless the excision of the involved area is of such extent that delayed, staged reconstructive procedures are mandatory. Nevertheless, the advances in surgical techniques, anesthesia, blood and fluid replacement, nasogastric tube feeding, and other fields, have enlarged the scope and possibilities of primary reconstructive