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Gabriele Molteni, Andrea Sacchetto, Luca Sacchetto, Daniele Marchioni Otolaryngology –Head and Neck Surgery, Department of Surgery, University of Verona, Verona, ItalyCorrespondence: Andrea SacchettoOtolaryngology-Head and Neck Surgery, Department of Surgery, University of Verona, Verona, ItalyTel +39-45-8122330Fax +39-45-8122313Email andrea.sacchetto89@gmail.comAbstract: The pharyngocutaneous fistula (PCF) is one of the most common post-operative complications in patients undergoing laryngectomy. Up till now, there is no universally accepted algorithm for managing of PCFs and several treatment modalities are used for wound healing. The English language literature was searched using PUBMED databases with the keywords “laryngectomy”, “pharyngocutaneous”, “fistula”, “treatment”, and “management” from January 1, 1999 to June 1, 2019; we selected 35 studies according to inclusion criteria and we conducted a systematic review of the articles. The analysis of the international literature shows a high variability of treatment approaches; there is no consensus about conservative treatment and waiting time, and neither about the indication for surgical treatment or the ideal surgical technique. A first attempt of a conservative measure is mandatory in all cases of PCF. In case of failure of conservative measures surgical treatment should be considered: direct closure and local flap are suitable for small defects, pedicled or free flaps showed good to excellent results in closure of large and complex cervical defects. Other non-invasive treatment such as hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT) showed promising results but in limited case series.Keywords: laryngectomy, pharyngo-cutaneous fistula, reconstructive surgery, hyperbaric oxygen therapy, negative pressure wound therapy, laryngeal cancer

Eugenia Allegra,1 Ignazio La Mantia,2 Maria Rita Bianco,1 Gaetano Davide Drago,3 Maria Cristina Le Fosse,1 Alfio Azzolina,4 Calogero Grillo,2 Vincenzo Saita41Otolaryngology, Department of Health Science, University of Catanzaro, Catanzaro, Italy; 2Otolaryngology, "G.F Ingrassia" Department, University of Catania, Catania, Italy; 3Grand Hôpital de l’Est Francilien, Jossigny, France; 4Otolaryngology Unit, Cannizzaro Hospital, University of Catania, Catania, ItalyIntroduction: Total laryngectomy has important psychophysical and social consequences for patients’ quality of life because of the functional changes resulting from the removal of the larynx. Voice deprivation is perhaps the most relevant limiting factor in social relationships, increasing feelings of solitude and tending to drive individuals into social isolation. Multiple voice rehabilitation methods after total laryngectomy are available. This study aimed to determine the acoustic quality of the rehabilitated voice achieved with esophageal speech (ES) and tracheoesophageal speech (TES), and acoustic quality impacts on patients’ perceptions of their quality of life.Materials and methods: The patient inclusion criterion was the completion of a speech rehabilitation course with ES or TES at least 6 months after total laryngectomy. The voice acoustic analysis was carried out automatically by using the Multidimensional Voice Program. The following parameters were extracted: fundamental frequency (F0), Jitter% (Jitt), Shimmer% (Shim), and noise-to-harmonic ratio (NHR). Subjective voice evaluation was performed by using the following questionnaires: Voice Handicap Index (VHI), Voice-related Quality of Life (V-RQOL), and Voice Performance Questionnaire (VPQ).Results: The acoustic analysis showed a difference between ES and TES patients on all acoustic parameters; this difference was significant for F0 (133.09±2.4 and 119±3.3, respectively; p

Objectives:To assess the oncologic efficiency and functional outcome of near total laryngectomy operation.Methods:A retrospective review of 10 cases of near total laryngectomy carried out in fiiflli Etfal Training and Research Hospital between 2001-2007. Oncologic success was evaluated according to the location, TNM stage and recurrence of tumour. Functional outcome was evaluated according to the aspiration and phonation.Results:All patients were men. Average age of the patients was 62.3 changing between 39-83. Mean phonation time was 28 days. Mean onset of oral intake was 16.5 days. One patient died of the disease because of distant metastasis. All patients had T3 lesions. Seven patients had N0, two patients had N1 and one patient had N2c neck. The four-year diseasefree survival was 90%.Conclusion:Near total laryngectomy is useful for the treatment of selected cases of advanced laryngeal cancer. Voice preservation can be achieved in most cases.