Clinical profile of post-operative complications of total laryngectomy for laryngeal carcinoma: a 12-year observation in Sokoto, Nigeria

Abstract

Background: Laryngeal carcinoma is the most common malignancy of the head and neck.

Objective: To determine the pattern of post-operative complications following total laryngectomy and to highlight the predisposing factors in our centre.

Methodology: This was a retrospective chart review of 30 patients who consented to total laryngectomy following histologically confirmed laryngeal carcinoma from December 2000 to December 2012.

Results: In the 12years under review, 30 (58.8%) patients consented to total laryngectomy. Twenty-three (76.7%) were males, while 7 (23.3%) were females, with a male: female ratio of 3.3:1. The age range was 20–75years, with a mean age of 50.1years. Post-operative complications were observed in 20 (66.7%) patients. The most common post-operative complications in this study were wound infection and pharyngocutaneous fistula, 4 (20%) cases, each. Others were tracheostomal stenosis 2 (10%), carotid blow out haemorrhage 3 (15%), stomal recurrence 2 (10%), pharyngeal stenosis 3 (15%) and hypocalcaemia 2 (10%). Common organisms isolated from wound swab were the pseudomonas species, which were treated with appropriate antibiotics. Predisposing factors observed in this study were middle age, cigarette smoking, co-existing medical condition, clinical and histologically high-grade cancer.

Conclusion: Meticulous pre-operative planning, good surgical technique and post-operative care will reduce these devastating complications.

Keywords: Cigarette smoking, haemorrhage, otorhinolaryngology, pharyngocutaneous fistula