Complications of Total Laryngectomy

Objective: To find out various complications after total laryngectomy, with reference to their presentation, diagnosis, and management. Design: It was a prospective descriptive study. Setting: Otolaryngology, Head and Neck Surgery department, Pakistan Institute of Medical Sciences Islamabad, from 1st July 1999 to 31st June 2001. Patients and Methods: 25 patients undergoing total laryngectomy for proven carcinoma larynx (Ca larynx) were included in this study. Patients were reviewed after surgery and any complication that occurred was recorded. The presentation, diagnosis, and management of these complications are discussed, along with voice rehabilitation after total laryngectomy. Results: There were 23 males and 2 females. Age of patients ranged from 40 – 65 years. Complications included wound infection (06), pharyngocutaneous fistula (03), pharyngeal stenosis (03), and nodal metastasis (02). Conclusions: Wound infection and pharyngocutaneous fistula are most common complications after total laryngectomy. Preoperative radiotherapy and low postoperative haemoglobin level are important risk factors for development of pharyngocutaneous fistula in total laryngectomy patients. Postoperative radiotherapy to the neck reduces the risk of nodal metastasis after total laryngectomy.