Anesthesia challenges in a post-laryngectomy patient with acute unhealed stoma for pharyngocutaneous fistula repair

• Author Details:   
• Naba Mateen Madoo ^*
• Jay Atul Kothari
• Ravi kumar R.

Pharyngocutaneous fistula (PCF) is a known complication following total laryngectomy, especially in patients who have undergone radiotherapy and present with multiple comorbidities, such as ischemic heart disease, diabetes, and hypertension. This case report presents the anesthetic challenges of managing a 75-year-old male with an unhealed stoma, who underwent surgical repair for a PCF. The patient had a complex history, including 35 cycles of radiotherapy, ischemic heart disease, diabetes, and hypertension. A multidisciplinary perioperative strategy was employed, focusing on airway management, hemodynamic optimization, and infection control measures. This case underscores the need for a tailored anesthetic approach in high-risk post-laryngectomy patients, highlighting the importance of careful planning and multidisciplinary collaboration.

Keywords: Pharyngocutaneous fistula, Total laryngectomy, Anesthesia, Fiberoptic intubation, Airway management, Hemodynamic optimization, Perioperative care