Surgical emphysema as an early sign for pharyngocutaneous fistula following total laryngectomy: a case report

Background Pharyngocutaneous fistula is the most common and troublesome complication after total laryngectomy. Many factors may be used in laryngectomy patients for the early diagnosis of pharyngocutaneous fistulae such as skin flap edema, neck erythema, salivary leak, postoperative barium swallow, and wound amylase level. Its diagnosis is mainly standing on a clinical basis. Case presentation This report described two cases of laryngeal carcinoma, which presented with a history of persistent hoarseness of voice and mild stridor and were diagnosed with a battery of clinical investigations and managed successfully with total laryngectomy and lateral neck dissection. Both patients suffered from postoperative surgical emphysema before developing pharyngocutaneous fistula. Conclusion Surgical emphysema can precede the occurrence of pharyngocutaneous fistula after total laryngectomy. Further studies are needed to confirm this finding.