Medical Treatment of Pharyngo-Cautaneus Fistula After Laryngectomy with Phenytoin,Clindamycin, Acetic Acid and Dexamethasone Combination in 50 Patients Affected By Laryngeal Cancer in Emam Hospital, Ahvaz,IRAN During 2001-2008

[摘要] BackgroundandObjective:pharyngo-cautaneusfistulaisthemostcommoncomplication(8.7%-22%)afterlaryngectomy.Multiplefactorssuchasradiotherapyareassociatedwithcomplicationsafterlaryngectomy.Spiteofthedifferenttreatmentssuchaslocal,regionalandadvancedflaps,theidealmethodforclosinglargfistulaofpharyngo-cautaneusisstiilamaterfordebate.SubjectsandMethods:Inthisinvestigation,8casesfrom50patientsbetween2001-2008asprospectiveand19controlsfrom130patientsbetween2001-2008asretrospectiveunderwenttotallaryngectomyforlaryngealcancerinEmamKhomeinihospital,Ahvaz,Iran,werechosen.Allofthecasesunderwentantibiotictherapy,irrigationofwoundwithsolutionofclindamycin,aceticacid,dexamethasoneandphenytoinandchangeofdressing4timeinday.Results:Inthecaseandcontrolgroups,8(16%)and19(14%)patientswereaffectedbypharyngo-cautaneusfistula.Inthecasegroup,sixpatientsunderwentradiotherapybeforeoperation(12%).Themeantimeforbeginningfistulaformationandrepairincasesandcontrolgroupwas6.5,9.6and27,24respectively.Allofthesecasesrespondedwelltothismedicaltherapymethodand2patientsfromcontrolgroupneededsurgeryforfistularepair.Conclusion:Inthisstudyshowedthatthelargefistulainpatientswithradiotherapycanalsobecurewithnon-surgicaltreatmentandspecialcares.

[学科分类] 基础医学