Negative Pressure Wound Therapy in Pharyngocutaneous Fistula.

Pharyngocutaneous fistula (PCF) is an abnormal connection between the pharynx and skin that can occur after laryngectomy surgery. It can have a significant negative impact on patient recovery, delaying wound healing, requiring prolonged nil-per-oral (NPO) status, and reducing quality of life. Traditionally, the management of PCF has relied on conservative measures or surgical intervention. However, negative pressure wound therapy (NPWT) offers a promising alternative approach. This case study involves three patients who underwent laryngectomy and developed postoperative PCF. All patients received NPWT with a modified suction catheter and low negative pressure (20-40 mmHg). With NPWT, all patients achieved complete wound closure, with healing times ranging from two weeks to six weeks. This suggests that NPWT may significantly accelerate PCF healing compared to traditional methods. However, maintaining an airtight dressing on the neck region can be challenging. This study highlights the potential of NPWT for faster PCF closure after laryngectomy. Further research is needed to optimize NPWT application techniques, explore the impact on long-term outcomes, and establish guidelines for broader clinical use.

Infected Cochlear Implant and Re-implantation in a Pediatric Case.

Cochlear implant (CI) surgery is relatively safe, however reports of complications and failure following cochlear implant surgery are higher nowadays due to the increasing number of patients with CI. Herein, we report a case of infected cochlear implant 10 months after surgery. A three-year-six-month-old girl underwent right cochlear implantation for bilateral profound sensorineural hearing loss. From day one until six months after the surgery, it was uneventful and the wound healed well. However, at 10 months post-surgery, she presented with a chronic discharging wound over the previous surgical site. Despite being on IV antibiotics for six weeks and daily dressing, the wound over the implant site keep discharging and eventually the implant was removed two months later. She was later re-implanted with a cochlear implant on the same side at the age of five years 10 months old. Currently, she is showing good speech improvement with the right CI. Her aided hearing threshold is at 30-40 dB at all frequencies. Early diagnosis is crucial, and the proper course of action should be taken as soon as possible if implant failure is suspected. Prior to implant surgery, any potential risk factors that could lead to implant failure should be identified and addressed appropriately to reduce the risk of an infected cochlear implant.