[Coincidence of Fistula Enlargement and Supra-oesophageal Reflux in Patients After Laryngectomy and Prosthetic Voice Restoration]

Overview

Journal HNO

Specialty Otorhinolaryngology

Date 2009 Sep 4

PMID 19727628

Citations 15

Authors

K J Lorenz

T Ehrhart

L Grieser

H Maier

Affiliations

Soon will be listed here.

Abstract

Introduction: In a prospective study on patients who developed recurrent periprosthetic leakage in the region of the fistula after laryngectomy and prosthetic voice restoration, we investigated whether there was an increased incidence of supra-oesophageal reflux.

Patients And Methods: A total of 48 patients included 16 patients with recurrent periprosthetic leakage (group A) and 32 patients without periprosthetic leakage (group B). The presence of reflux was objectively assessed using 24-hour dual-probe pH monitoring. The number of supra-oesophageal reflux events, the reflux area index (RAI 4) and the DeMeester score were determined as well as the relative risk of fistula enlargement in relation to the presence of reflux and postoperative radiotherapy.

Results: In group A pathological reflux events were detected in 100% of the cases. The mean number of supra-oesophageal reflux episodes was 414.8, the RAI was 419.5 (+/-212.45) and the DeMeester score was 104.4 (+/-21.3). In group B pathological reflux events were found in only 50% of the cases. The mean number of supra-oesophageal reflux episodes was 11.8, the RAI was 146.9 (+/-40.4) and the DeMeester score was 42.9 (+/-11.8). All reflux parameter results for group A patients were significantly higher than those obtained for group B patients. The relative risk of fistula enlargement was 1.8-2.3 times higher in the presence of reflux. Postoperative radiotherapy did not increase the risk of fistula enlargement (relative risk 0.75-0.93).

Conclusions: A significantly higher number of supra-oesophageal reflux episodes occurred in patients with recurrent periprosthetic leakage in the region of the fistula. As reflux events may cause problems in the region of the fistula, prophylactic treatment with proton pump inhibitors is recommended.

Citing Articles

Solving periprosthetic leakage with a novel prosthetic device.

Petersen J, Lansaat L, Hilgers F, van den Brekel M Laryngoscope. 2018; 129(10):2299-2302.

PMID: 30467857 PMC: 6859417. DOI: 10.1002/lary.27645.

Post-laryngectomy voice rehabilitation with voice prosthesis: 15 years experience of the ENT Clinic of University of Catania. Retrospective data analysis and literature review.

Serra A, di Mauro P, Spataro D, Maiolino L, Cocuzza S Acta Otorhinolaryngol Ital. 2016; 35(6):412-9.

PMID: 26900247 PMC: 4755057. DOI: 10.14639/0392-100X-680.

Novel modification of voice prosthesis.

Al Kadah B, Papaspyrou G, Schneider M, Schick B Eur Arch Otorhinolaryngol. 2015; 273(3):697-702.

PMID: 26463715 DOI: 10.1007/s00405-015-3795-2.

[Solving problems after rehabilitation with voice prostheses : Two rare cases of fistula-related complications].

Lorenz K, Nolte S HNO. 2015; 64(7):508-14.

PMID: 26403994 DOI: 10.1007/s00106-015-0059-9.

[Voice rehabilitation after total laryngectomy: A chronological review of medical history].

Lorenz K HNO. 2015; 63(10):663-4, 666-80.

PMID: 26403993 DOI: 10.1007/s00106-015-0043-4.

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