After total laryngectomy, which complication would be least of concern?

After total laryngectomy, which complication would be least of concern?

• A. Aspiration of the bolus
• B. Stricture of the UES
• C. Abnormal tissue pockets in the pharynx
• D. Development of a fistula

Answer: (A)

After total laryngectomy the airway and the esophagus are separated, so swallowing no longer poses a direct risk of material entering the lungs. This makes aspiration of the bolus largely unlikely and thus the least concern among the listed possibilities. However, other issues can still arise: scarring at the upper esophageal sphincter can narrow that junction (a stricture), causing difficulty with the passage of the bolus; abnormal tissue pockets in the pharynx can form and trap material, leading to residue and clearance problems; and a pharyngocutaneous fistula can develop, creating an abnormal link between the pharynx and the skin and posing infection and healing challenges.

After total laryngectomy the airway and the esophagus are separated, so swallowing no longer poses a direct risk of material entering the lungs. This makes aspiration of the bolus largely unlikely and thus the least concern among the listed possibilities. However, other issues can still arise: scarring at the upper esophageal sphincter can narrow that junction (a stricture), causing difficulty with the passage of the bolus; abnormal tissue pockets in the pharynx can form and trap material, leading to residue and clearance problems; and a pharyngocutaneous fistula can develop, creating an abnormal link between the pharynx and the skin and posing infection and healing challenges.