All patients undergoing surgery of the upper aerodigestive tract are at risk of pharyngocutaneous fistula, even in the hands of the most technically competent surgeons. The first laryngectomy carried out by Billroth in 1873 was complicated by a large pharyngocutaneous fistula and eventual death. The current incidence of pharyngocutaneous fistula after laryngectomy varies widely in the literature. Giordano et al.1 report an average fis-tulization rate of 17%, whereas Weissler2 ranged from 9% to 21%, and Papazoglou et al.3 note an incidence varying between 2 and 66%.

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