[abstract] A rare tracheopharyngeal fistula in radiated field healed with hyperbaric oxygen treatments and surgery

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[abstract] A rare tracheopharyngeal fistula in radiated field healed with hyperbaric oxygen treatments and surgery

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Title: [abstract] A rare tracheopharyngeal fistula in radiated field healed with hyperbaric oxygen treatments and surgery
Author: McArthur, CL
Abstract: Background: Patients with malignancies of the head and neck frequently have major surgery followed by radiation therapy. Complication can range between 20- and 50 percent in laryngectomy patients. Prolonged healing with recurrent pulmonary infections and malnutrition are common. Fistula formation occurs with an incidence of 5-30 percent, pharyngocutaneous being most common. Tracheoesophageal fistula and tracheopharyngeal fistula (TPF) are not common. Hyperbaric oxygen therapy (HBO2T) is a treatment in which a patient breathes 100 percent oxygen intermittently while inside a treatment chamber at a pressure higher than sea level. Most TPFs have required surgery for repair of the defect. A case is reported of a patient with bleeding from the tracheal stoma. She had a workup and noted to have TPF. She had at least three procedures, including biopsy, to exclude recurrent or new cancer. She then underwent HBO2T, and the TPF rapidly healed. No reports of HBO2T for TPF were identified. Materials and methods: This is a case report of a patient with large TPF in a radiated field. She presented with bleeding. She has staged procedures to close the TPF. The fistula failed to heal on at least three attempts. She was unable to swallow and required a feeding tube. This helped stabilize her weight. She then had multiple HBO2Ts, and the TPF rapidly began to close from the size of a quarter to that of a pinhole. The skin and other tissue in the radiated field have greatly improved from a leatherlike fibrotic texture to a nearly normal supple texture. Results: The patient has improved from a malnourished soul with a large TPF to a well-healed lady and return of a more normal lifestyle. Summary: Patients with neck radiation therapy who later develop complication at a later time should be considered early for adjunctive HBO2T.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/9991
Date: 2011

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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