Background Pharyngocutaneous fistula (PCF) following laryngectomy is a serious complication, and its incidence varies from 7.6% to 50%. Despite the relative frequency of this complication, there is still uncertainty about the predisposing factors. Methods A retrospective study was performed in 295 patients who underwent total laryngectomy. Results Of the 295 patients, 37 (12.5%) developed PCF. The contributing factors,—such as early oral feeding postoperatively, prior radiotherapy or tracheostomy, accompanying neck dissection,—and the surgical technique failed to show a statistically significant effect. There was statistically significant association between tumor size and PCF formation. Also, when the suture materials used for the closure of the pharynx were compared, catgut showed a higher rate of PCF formation than vicryl (p < .05). Conclusions The vicryl, when used as a suture material for the closure of the pharynx, seemed to decrease the fistula rate significantly, compared with catgut. Also, tumor stage was found to have a significant role in PCF formation, but no statistical significant difference could be demonstrated for other investigated parameters. We believe that after total laryngectomy, oral feeding can be started at the third postoperative day without increasing morbidity, which makes the patients feel more comfortable and confident without nasogastric tube. © 1998 John Wiley & Sons, Inc. Head Neck 20: 22–25, 1998.

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Purpose: To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction. Methods: Twenty-six patients (29 eyes) with congenital nasolacrimal duct obstruction, who ranged in age from 2 to 12 years (mean, 4.85 ± 2.9 years), underwent silicone intubation with the Ritleng lacrimal intubation system. The Ritleng lacrimal intubation system is composed of a Ritleng probe, a monofilament guide thread and a silicone tube. The prolene tip was removed from the inferior meatus with nasal endoscopy in 26 eyes, whereas this was done by using a Ritleng hook in 3. Clinical success was defined by the relief from symptoms and signs of obstruction. The tubes were left in place for an average of 6 months. The patients were followed up between 6 and 25 months (mean, 8.3 months). Results: All cases were successfully intubated with the Ritleng system. Two cases underwent reintubation because of tube dislocation during the first week. Granuloma developed at the edge of the inferior punctum in 1 case. We observed relief from symptoms in all cases. Conclusion: The Ritleng lacrimal intubation system is an easy, effective and nontraumatizing procedure for the treatment of congenital nasolacrimal duct obstruction.

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