Management of Traumatic Tracheoesophageal Fistula

Gerwat, John; Bryce, Douglas P.

doi:10.1001/archotol.1975.00780300071019

Cited by 12 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They are incompatible with normal life and are fortunately uncommon. Acquired laryngotracheal fistulae may arise as a result of trauma such as one caused by a wire or cable [2]. Crush injuries against the steering wheel have been reported [7].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of acquired laryngopharyngeal fistulae

Tiwari¹,

Mahieu²

1999

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical management of acquired laryngopharyngeal fistulae

Tiwari¹,

Mahieu²

1999

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

show abstract

“…Although techniques that make use of transtracheal microsurgical repairs, 2 skin flaps, 3 and fascia lata grafts 4 have shown early success, they are associated with a high rate of stenosis and recurrent fistulas. Most surgeons have tried to reinforce the TEF closure by interposing viable well‐vascularized tissue, and a variety of muscle flaps have been described for this purpose including the use of the sternohyoid muscle, 5 the sternocleidomastoid muscle, 6 intercostal muscle, 7 latissimus dorsi muscle, 8 and pectoralis major muscle 9 . Radial forearm fasciocutaneous free flaps have been used to treat persistent tracheoesophageal speech fistulas 10,11 …”

Section: Discussionmentioning

confidence: 99%

Split Pectoralis Major Flap for Massive Tracheoesophageal Fistula

Alemar

Anand

1997

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Large tracheoesophageal fistulas (TEFs) occurring after a total laryngectomy are rare. Most often they are associated with the creation of a surgical speech fistula or puncture and the stomal recurrence of the malignant tumor. A large TEF is frequently complicated by significant nutritional problems and recurrent pulmonary infections; therefore it presents the surgeon a challenge for successful repair. Furthermore the effects of previous radiation therapy compound the problem by adversely affecting healing.We present two case reports of patients with large, delayed, nonmalignant TEFs after total laryngectomy. Neither case involved the creation of a speech fistula, and both patients underwent successful repair with a split myofascial pectoralis major flap. The surgical technique is described and pertinent literature reviewed. CASE REPORTSCase 1. Three years after undergoing a total laryngectomy for an advanced transglottic carcinoma (T4NOM0), a 63year-old man came to us with a report of progressive dysphagia for 5 months and coughing spells for 1 month. The patient noted frank coughing of food and weight loss of 100 pounds. After the laryngectomy he had received a postoperative radiation dose of 6300 cGy.On examination the patient was found to have a massive TEF that extended 5 cm below the stomal margin along the tracheoesophageal wall. The borders of the fistula were mature, and no associated tumors or mucosal lesions were seen. He had decreased breath sounds, and rhonchi were present at the right lower lobe on auscultation. A chest x-ray evaluation confirmed right lower lobe pneumonia. On his admission to the hospital the patient's oral feedings were stopped, and an enteral feeding tube and a cuffed tracheostomy tube were placed to stop aspiration. Aggressive respiratory therapy and intravenous antibiotics cleared the pneumonia. Enteral tube feedings improved the patient's nutritional status, his serum albumin levels increased from 2.7 to 3.2 gm/dl, and he gained 15 pounds. The patient underwent a metastatic workup that included CT of the chest and neck, a liver

show abstract

Transtracheal microsurgical closure of tracheoesophageal fistulas

Gerhardt¹

1981

Head Neck

View full text Add to dashboard Cite

A patient with a 1.5- to 2.5-cm tracheoesophageal fistula secondary to prolonged assisted ventilation and feeding by a nasogastric tube was operated upon by a transtracheal microsurgical approach. The advantages of this approach are as follows: (1) the surgery is not extensive and therefore does not cause much stress to the patient; (2) this technique avoids the necessity for a wide mediastinotomy or sternotomy and thoracotomy, and therefore averts the danger of a widespread infection with the highly antibiotic-resistant bacteria that are always present in these cases; and (3) there is no risk of damage to the recurrent nerve. The ENT surgeon who is well-trained and experienced in microsurgery should try this approach in selected cases first. If this method fails, other methods are still available.

show abstract

Management of Traumatic Tracheoesophageal Fistula

Cited by 12 publications

References 8 publications

Surgical management of acquired laryngopharyngeal fistulae

Surgical management of acquired laryngopharyngeal fistulae

Split Pectoralis Major Flap for Massive Tracheoesophageal Fistula

Transtracheal microsurgical closure of tracheoesophageal fistulas

Contact Info

Product

Resources

About