Untersuchungstechnik der sonographischen Kontrolle des Pharynxverschlusses nach Laryngektomie*

Background: The pharyngocutaneous fistula presents the most common complication after laryngectomy. Despite applying methods of pharyngeal closure, local factors such as irradiation may cause healing disturbances and the development of pharyngeal fistula. Before the nasogastric feeding tube is removed, an additional radiologic control with water-soluble contrast medium is recommended in literature in case of normal clinical healing. Methods: The radiologic method was compared with a newly developed sonographic examination technique. Using the so-called "aerophagia maneuver" in sonography, an arising of peripharyngeal air before the "aerophagia maneuver" or a peripharyngeal mass lesion was an uncertain criterion for a pharyngeal fistula. Peripharyngeal air may be seen also due to infection with anaerobic bacteria, and peripharyngeal mass lesion may be caused by seroma or hematoma. In sonography, tissular air is seen typically, in a hyperechoic reflex with distal repetitions. Results: Radiologic examination of the pharynx in 18 laryngectomy patients revealed fistulas in three cases. Conclusions: Our experiences have shown so far that sonographic examination in combination with the so-called "aerophagia maneuver"' prove to be reliable or ascertaining pharyngeal closure after laryngectomy.