Pharyngo-cutaneous fistulae after laryngectomy. Influence of previous radiotherapy and prophylactic XXXX .

@entity1 @entity868 @entity5 @entity532 @entity189 @entity292
The development of a pharyngocutaneous fistulae is a major complication after total laryngectomy. In Denmark radiotherapy is the primary treatment for all @entity189 . Based on the experience with conventional daily irradiation, a split-course radiation schedule was introduced in 1978. The charts of 106 consecutive @entity1 laryngectomized for recurrence in the years 1975 to 1984 were examined. Thirty-four @entity1 developed a @entity292 . An evaluation of the different radiotherapy schedules used during this period allowed a dose-response curve to be constructed. It showed a pronounced increase of fistulae with high doses of radiotherapy. Split-course radiotherapy caused a @entity532 and did not improve @entity5 control. Large field sizes increased the number of fistulae. High-dose fractions showed a surprisingly high incidence of late complications. Prophylactic @entity868 (introduced in 1980) resulted in a highly significant decrease in the frequency of postoperative fistulae. @entity1 in whom @entity292 formed were hospitalized for an average of 54 days, @entity1 without, for 22 days.
