Role of blue dye test as an early predictor of post-laryngectomy pharyngocutaneous fistula

Background: Pharyngocutaneous fistula (PCF) is considered the most common suffering complication in laryngectomized patients. PCF occurs variably from 10 to 20% and sometimes reaches more than 60%, as a result of a combination of local and systemic factors related to poor tissue healing and wound breakdown. Development of PCF affects the restoration of normal life after laryngectomy that could potentially lead to major complications affecting patient survival. Aim of study: We studied the role of blue dye test in the early detection of PCF post-laryngectomy, which could potentially lead to optimum management which can reduce the duration of hospital stay as well as major complications out of salivary leakage. Results: Out of 64 patients who underwent TL from Jan 2020 till Dec 2021 at a Tertiary Head and Neck Cancer Center, 40 patients were included in the study. All these patients underwent blue dye test and barium swallow considered the standard postoperative leak test. Patients’ characteristics as well as associated comorbidities have been studied as well as blue dye test findings compared to barium swallow, including median time for diagnosis of PCF, duration, management plan, additional leak tests, and length of hospital stay. Conclusion: Blue dye test gives a good clue for early detection with proper management of PCF, which could eventually result in early recovery and reduce cost, morbidity, and hospital stay. It can be repeatedly performed to establish a simple, reliable, and safe bedside tool for follow-up.