A Prospective Study on Local Complications of Primary Total Laryngectomy/Laryngopharyngectomy for Laryngeal and Hypopharyngeal Malignancies

Background: Carcinoma larynx is one among the most common head and neck malignancy which accounts for 2% of all cancers whereas hypopharyngeal cancer is one of the most aggressive tumor with poorer prognosis. Total laryngectomy/laryngopharyngectomy (TL/TLP) is the treatment of choice for locally advanced laryngeal and hypopharyngeal cancers. Objectives: To study the complications associated with primary TL/TLP along with the sociodemographic profile and clinicopathologic features of laryngeal and hypopharyngeal cancers. We also aimed to assess the risk factors associated with complications. Methods: All stage III or IVA laryngeal and hypopharyngeal malignancy cases as per American Joint Committee on Cancer (AJCC) 8th edition staging, who underwent primary total laryngectomy/total laryngopharyngectomy during the year 2018-2019 in our institute, KIMS Hubli, have been studied. Sociodemographic profile and clinicopathological features were noted. These patients were followed up for 6 months for any local complications. Results: Mean age of the study population was 58 years with male predominance. Primary glottic carcinoma was most common. Most common presenting symptom was change in voice and most common anatomical site involved was true cords. Overall complication rate was 32%. Most common complication encountered was wound infection and pharyngocutaneous fistula (8% each). As complications set in length of hospital stay increases. We found significant association with PCF and length of hospital stay. Conclusion: With proper case selection, and regular wound care, complications can be avoided in case of TL/TLP. Once complications set in, it increases hospital stay and the expenditure, hence is traumatizing to the patient and hence should be avoided.