Tracheocutaneous fistula in patients undergoing supracricoid partial laryngectomy: the role of chronic aspiration

被引:0
作者
de Virgilio, A. [1 ,2 ]
Simonelli, M. [3 ]
Greco, A. [1 ,2 ]
Gallo, A. [4 ]
Moretta, A. [2 ]
Wang, C. C. [5 ,6 ,7 ]
Martellucci, S.
Calcagno, P. [3 ]
de Vincentiis, M. [1 ,2 ]
机构
[1] Univ Roma La Sapienza, Dept Surg Sci, Rome, Italy
[2] Univ Roma La Sapienza, Dept Surg Sci, Rome, Italy
[3] Santa Lucia Fdn, Speech & Swallowing Rehabil Serv, Rome, Italy
[4] Univ Roma La Sapienza, Dept Surg Biotechnol & Sci, ENT Sect, Rome, Italy
[5] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan
[6] Chung Shan Med Univ, Sch Speech Language Pathol & Audiol, Taichung, Taiwan
[7] Taichung Vet Gen Hosp, Dept Otolaryngol Head & Neck Surg, Taichung, Taiwan
关键词
Aspiration; Risk factors; Supracricoid partial laryngectomy; Tracheocutaneous fistula; Tracheostomy; CRICOHYOIDOPEXY; TRACHEOSTOMY; CARCINOMA;
D O I
暂无
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
The aim of the present retrospective controlled study was to analyse and compare risk factors for tracheocutaneous fistula in patients who received tracheostomy after supracricoid partial laryngectomy with those who received tracheostomy for other causes. We enrolled 39 patients with tracheocutaneous fistulas who were divided into two groups. The first received temporary tracheostomy for supracricoid partial laryngectomies (n = 21), while the control group consisted of patients who received temporary tracheostomy for other causes (n = 18). Risk factors believed to play a role in the pathogenesis of tracheocutaneous fistula were examined including advanced age, cardiopathy, local infections, radiotherapy, elevated body mass index, malnutrition, decannulation time and aspiration grade. The Leipzig and Pearson scale score was significantly higher in the supracricoid partial laryngectomy group (p = 0.006 and 0.031 for univariate and multivariate analyses, respectively). The penetration/aspiration scale score was significantly higher in the supracricoid partial laryngectomy group as determined by univariate analysis (p = 0.014). The decannulation time was significantly lower in the supracricoid partial laryngectomy group (p = 0.004 and 0.0004 for univariate and multivariate analyses, respectively). The number of surgical closures for tracheocutaneous fistula was significantly higher in the supracricoid partial laryngectomy group by univariate analysis (p = 0.027). These results suggest that chronic aspiration and related cough may be important pathogenic factors for tracheocutaneous fistula and could be responsible for the significantly higher rates of closure failure in patients after supracricoid partial laryngectomy.
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页码:9 / 14
页数:6
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