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Pharyngeal contancous fistula on neck, CT scan shows destroyed hyoid bone. Surgery to repair it?

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My husband has a pharengeal contancous fitisula on the left side of his neck right under his jaw. A CT scan results states that the Hyoid bone has been partially destroyed. I could see it in the hole, now that bone has broken into. Is there a surgery that could repair that and close the hole up on the side of his neck leaving the fitisula open on the inside? They say that this developed from poor nutrition while undergoing chemo for coloretal cancer. He previously has squeamoucell carsonoma of the base of the tounge (16 years ago) and this area was treated with a neck recection and radiation.
Posted Wed, 3 Oct 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 3 hours later

Thank you for your query.

1. The hyoid bone does not require any repair.

2. Since the hyoid bone appears partially destroyed, a biopsy may be necessary before attempting a repair.

3. The prior surgery must have included a neck dissection which thins out the neck wall, with extensive fibrosis and damage to the blood supply. The prior radiation therapy, chemotherapy, compromised nutrition or a recurrence may have a role in its formation.

4. The most common reason of a pharyngocutaneous fistula is a total laryngectomy and rarely neglected foreign bodies. Such delayed fistulas are rare.

5. The main treatment is to reduce or drain the pharyngeal secretions and operate the fistula after it is reasonably dry. A flap may be necessary to aid closure. Intrasite gel is a good wound dressing

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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