Variability of the incidence and risk factors for the development of pharyngocutaneous fistula after laryngectomy in different time periods
09-10, 17:00–17:30 (Europe/Istanbul), Head & Neck Oncology 3

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<p>Background & Aim:</p> <p>The pharyngocutaneous fistula (PCF) is the most common complication following a laryngectomy (LE) with a wide range of incidence and various potential risk factors. This study aimed to analyse the variability in the incidence and to identify the underlying causes for fluctuations in incidence rates.</p> <p>Material & Methods:</p> <p>In the retrospective study, the annual PCF incidence data and comprehensive clinicopathologic data from 540 patients who underwent TLE between January 2004 and December 2022 were reviewed. Distinct periods of both high and low PCF incidence were identified. Within these periods, patients were categorized into groups with PCF (study groups) and without it (control groups). These groups were statistically compared based on potential risk factors for PCF development. The high-incidence periods were specially analysed for recurring risk factors and the corresponding corrective measures were reviewed.</p> <p>Results:</p> <p>The analysis revealed four high-incidence periods with an overall PCF incidence of 37.61%, along with three low-incidence periods in between with an overall incidence of 19.38%. Surgical wound infection (SWI) and a history of head and neck cancer alongside their related treatments were repeatedly identified as independent risk factors during high-incidence periods, with SWI being the most consistent predictor of PCF development.</p> <p>Conclusions:</p> <p>Continuous monitoring of PCF incidence is crucial, as it allows for the identification of emerging risk factors and the immediate implementation of corrective measures to mitigate these newly identified risk factors.</p>
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Session Chair Session Chair
Çağlar Eker
Speaker Speaker
Robert Šifrer
Çağlar Eker
<p>Dr. Çağlar Eker, MD</p> <p>Date and Place of Birth: June 19, 1988 – Niğde, Turkey</p> <p>Email: [email protected] | Phone: +90 506 775 58 47</p> <p>Address: Adana, Turkey</p> <p>EDUCATION</p> <p>Otorhinolaryngology and Head & Neck Surgery Residency</p> <p>Cerrahpaşa Medical School, Istanbul University (2014–2018)</p> <p>Medical School</p> <p>Istanbul Faculty of Medicine, Istanbul University (Graduated: 2013)</p> <p>PROFESSIONAL EXPERIENCE</p> <p>Resident Physician</p> <p>Department of ENT and Head & Neck Surgery, Cerrahpaşa Medical School (2014–2018)</p> <p>ENT Specialist</p> <p>Islahiye State Hospital, Gaziantep (2018–2021)</p> <p>Assistant Professor</p> <p>Department of ENT and Head & Neck Surgery, Çukurova University Faculty of Medicine (2021–Present)</p> <p>LANGUAGES</p> <p>English: Advanced</p> <p>SELECTED PUBLICATIONS</p> <p>Eker Ç. et al. Clinical and Radiological Predictors of Oncological Outcomes in T1 Glottic Cancer. Eur Arch Otorhinolaryngol, 2024.</p> <p>Eker Ç, et al. Investigation of Post-Earthquake Dizziness After 2023 Türkiye Earthquakes: An Observational Case-Control Study. J Int Adv Otol. 2024</p> <p>Eker Ç. et al. TLR-2, -3, and -4 Gene Expressions in Laryngeal Squamous Cell Carcinoma. Turk Arch Otorhinolaryngol, 2022.</p> <p>Eker C, et al. Alternating pattern of rhino-orbital-cerebral mucormycosis with COVID-19 in diabetic patients. Eur Arch Otorhinolaryngol. 2023</p> <p>Eker Ç. et al. Predictive Models for Long-Term Hospitalization and Complications in Deep Neck Infections. ENT Updates, 2024.</p> <p>Over 10 publications in national and international peer-reviewed journals.</p> <p>CONFERENCE PRESENTATIONS</p> <p>Presented in numerous national and international congresses.</p> <p>Invited Speaker Topics:</p> <p>Orbital Exenteration (2022)</p> <p>Stapes Footplate Fistula (2022)</p> <p>Approach to Carotid Body Tumors (2023)</p> <p>Oral Cavity Reconstruction with Supraclavicular Island Flap (2023)</p> <p>CERTIFICATES</p> <p>European Board of Otorhinolaryngology, Head & Neck Surgery – Certificate of Proficiency, 2024</p> <p>Turkish Board of Otorhinolaryngology – Certificate of Proficiency, 2022</p> <p>Head & Neck and Thyroid Surgery School Certificate – Turkish ENT Society, 2022</p> <p>OBSERVERSHIP</p> <p>Netherlands Cancer Institute, Amsterdam (2024)</p> <p>Department of Head & Neck Surgery</p> <p>MEMBERSHIPS</p> <p>Turkish Society of Otorhinolaryngology – Head and Neck Surgery</p> <p>Çukurova Society of Otorhinolaryngology</p> <p>REFERENCES</p> <p>Prof. Dr. M. Mete Kıroğlu – Çukurova University, Faculty of Medicine</p> <p>Email: [email protected]</p> <p>Prof. Dr. H. Murat Yener – Cerrahpaşa Medical School, Istanbul University</p> <p>Email: [email protected]</p>
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Robert Šifrer
<p>1: Šifrer R, Urbančič J, Piazza C, van Weert S, García-Purriños F, Benedik J, Tancer I, Aničin A. Emergent tracheostomy during the pandemic of COVID-19: Slovenian National Recommendations. Eur Arch Otorhinolaryngol. 2021 Jul;278(7):2209-2217. doi: 10.1007/s00405-020-06318-8. Epub 2020 Sep 5. PMID: 32889621; PMCID: PMC7473826.</p> <p>2: Šifrer R, Benedik J, Aničin A. Elective open "Shield Tracheostomy" in patients with COVID-19. Eur Arch Otorhinolaryngol. 2022 Feb;279(2):891-897. doi: 10.1007/s00405-021-06820-7. Epub 2021 Apr 21. PMID: 33881578; PMCID: PMC8059421.</p> <p>3: Šifrer R, Strojan P, Tancer I, Dolenc M, Fugina S, Zore SB, Aničin A. The Incidence and the Risk Factors for Pharyngocutaneous Fistula following Primary and Salvage Total Laryngectomy. Cancers (Basel). 2023 Apr 12;15(8):2246. doi: 10.3390/cancers15082246. PMID: 37190174; PMCID: PMC10136624.</p> <p>4: Šifrer R, Aničin A, Pohar MP, Žargi M, Pukl P, Soklič T, Strojan P. Pharyngocutaneous fistula: the incidence and the risk factors. Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3393-9. doi: 10.1007/s00405-016-3963-z. Epub 2016 Mar 8. PMID: 26956981.</p> <p>5: Šifrer R, Dolenc M, Zore SB, Fugina S, Jesenko L, Strojan P. Temporal Variability in the Incidence and Risk Factors for Pharyngocutaneous Fistula Development after Total Laryngectomy. Cancers (Basel). 2024 Oct 15;16(20):3486. doi: 10.3390/cancers16203486. PMID: 39456580; PMCID: PMC11506730.</p> <p>6: Šifrer R, Rijken JA, Leemans CR, Eerenstein SEJ, van Weert S, Hendrickx JJ, Bloemena E, Heuveling DA, Rinkel RNPM. Evaluation of vascular features of vocal cords proposed by the European Laryngological Society. Eur Arch Otorhinolaryngol. 2018 Jan;275(1):147-151. doi: 10.1007/s00405-017-4791-5. Epub 2017 Oct 30. PMID: 29086006; PMCID: PMC5754403.</p> <p>7: Šifrer R, Šereg-Bahar M, Gale N, Hočevar-Boltežar I. The diagnostic value of perpendicular vascular patterns of vocal cords defined by narrow-band imaging. Eur Arch Otorhinolaryngol. 2020 Jun;277(6):1715-1723. doi: 10.1007/s00405-020-05864-5. Epub 2020 Feb 28. PMID: 32112142.</p> <p>8: Sifrer R, Strojan P, Zidar N, Zargi M, Groselj A, Krajinovic M. Distant metastasis of rectal adenocarcinoma in a temporary tracheostoma. Radiol Oncol. 2014 Nov 5;48(4):393-6. doi: 10.2478/raon-2013-0079. PMID: 25435853; PMCID: PMC4230560.</p> <p>9: Šifrer R, Urbančič J, Strojan P, Aničin A, Žargi M. The assessment of mucosal surgical margins in head and neck cancer surgery with narrow band imaging. Laryngoscope. 2017 Jul;127(7):1577-1582. doi: 10.1002/lary.26405. Epub 2016 Nov 15. PMID: 27859314.</p> <p>10: Jensterle S, Benedik J, Sifrer R. Tracheostomy before and during COVID-19 pandemic. Radiol Oncol. 2024 Jun 12;58(4):556-564. doi: 10.2478/raon-2024-0034. PMID: 38861690; PMCID: PMC11604258.</p>
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