COMPARATIVE STUDY BETWEEN METHYLENE BLUE DYE, VIDEOFLUOROSCOPY AND BARIUM SWALLOW AS PREDICTORS OF SALIVARY FISTULA AFTER PHARYNGEAL RECONSTRUCTION.

Abstract

Introduction:Pharyngeal reconstruction is essential in restoring swallowing, speech, and breathing functions in patients undergoing head and neck cancer surgery or trauma repair. Complications such as pharyngocutaneous fistula (PCF)—an abnormal connection between the pharynx and skin—remain a significant challenge. PCF increases patient morbidity, delays healing, and prolongs hospitalization. Risk factors for PCF include patient comorbidities, previous radiation, poor nutrition, and extensive surgery. Early and accurate diagnosis facilitates timely intervention, which improves patient outcomes and plays a crucial role in reducing the risk of complications. There is no single gold standard diagnostic tool. So, various diagnostic tools can be used such as methylene blue dye test, barium swallow, and videofluoroscopy. Each method has its strengths and limitations, making it necessary to compare their effectiveness. This study compares these diagnostic modalities to establish evidence-based recommendations for early PCF detection and better postoperative care.Aim:The aim of this study is to compare between the results of methylene blue dye test, barium swallow test and videofluoroscopy in patients undergoing pharyngeal reconstruction surgery to asses the best method for early detection of salivary fistula in order to start oral feeding.