OPTIONS OF SURGICAL MANAGEMENT OF RESISTANT PHARYNGEAL FISTULAE
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A major complication of head and neck cancer surgery is pharyngocutaneous fistula. this fistula is notified more after radiation and extensive pharyngeal resection (Dedo et. at 1975) . Eleven cases with failure to close-fistulae were the material of this study. Previous management was applied followed by failure to close. Different surgical procedures were carried out to close the fistulae : gastric pull up (six cases), micro-surgical free jujenal patch (2 cases), and local tongue flap (three cases). Each method will be discussed and the results will be analyzed. Six cases were recurrent after double island myocutaneous and/or delto- pectoral flap, two cases after extensive pharyngeal resection together with radical neck dissection and post-operative radiotherapy. The last three cases were to close wide pharyngos tome.