Complicated pharyngocutaneous fistula repair after head and neck cancer surgery: a case series of 7 patients.

Objective: To retrospectively analyze the repair of seven cases of complicated pharyngocutaneous fistula (PCF) to provide a reference for the treatment of complicated PCF.

Methods: We retrospectively analyzed the clinical data of seven patients with complicated PCF from February 2017 to December 2021, including six males and one female, with a history of neck radiotherapy in two cases. The range of PCF mucosal defects was 1.0 cm × 2.0-5.0 cm × 7.0 cm. A pedicled flap or free flap was chosen for repair depending on the site and size of the defect. A total of eight flaps were used to repair complicated PCF defects.

Results: One of the seven patients healed after conservative treatment. Among the five patients who underwent pedicled flap repair, three had first-intention healing, one had second-intention healing, and one had tumor recurrence with unhealed PCF. Free flap repair was performed in one case, which had first-intention healing.

Conclusion: Early, prompt, and appropriate treatment can prevent a PCF from progressing to complicated PCF. The repair of the complicated PCF needs to be individualized according to the patient's local defect and the surgeon's clinical experience.