Long-term oral intake through a salivary bypass tube with chronic pharyngocutaneous fistula

Pharyngocutaneous fistulae (PCFs) are a common complication after total laryngectomy. Patients with persistent PCFs are often kept nil by mouth and are dependent on feedings via a gastric tube. Our patient is a 65-year-old man who presented to our clinic in 2008 having a persistent PCF after a total laryngectomy who failed numerous attempts at reconstruction. We inserted a salivary bypass tube as a method of spanning the PCF and advanced his oral diet. He has been able to tolerate a regular diet 30 months postoperatively with no dysphagia and has gained weight. This is a demonstration of salivary bypass tubes as a useful adjunct to maintain oral intake in the presence of a persistent PCF.