Salivary bypass tube in managing persistent and large pharyngocutaneous and tracheoesophageal fistulas: a series of seven cases

Abstract Background A salivary bypass tube (SBT) is a silicone that directs oral content from the mouth to esophagus. We studied series of seven cases persistent and large neck fistulas different aetiologies assess beneficial use SBTs in each case. Case presentation total patients underwent SBT insertion, six were post-total laryngectomy with underlying laryngeal malignancy, one case was poor wound healing abscess after extensive drainage. Five have pharyngocutaneous fistula (PCF) two tracheoesophageal (TEF), all failed conservative multiple surgical management for closure, some concurrently having neopharynx stenosis. Post-insertion, able eat orally day 2 1-week. The duration usage month three PCF post-operatively, cases, healed removed without recurrence. other four (three post-radiotherapy stoma recurrence) planned lifelong use, ranging 4 months 3 years. outcome their dry, they tolerate well. There no intraoperative or immediate postoperative complications, complications observed temporary cases. Among who had longer term, localised pressure necrosis regional soft tissue resolved adjustment, another loose-fitting displaced distally into oesophagus larger tube. Conclusions safe, easy-to-apply, reduces morbidity, improves mental health, inpatient stay, overall patient's quality life TEF long-term usage.