Modified vacuum‐assisted closure (EndoVAC) therapy for treatment of pharyngocutaneous fistula: Case series and a review of the literature

BACKGROUND: Pharyngocutaneous fistula is a potential life‐threatening complication following head and neck surgery. There is only limited evidence about the efficacy of vacuum‐assisted closure (VAC) therapy and endoscopic vacuum‐assisted closure (EndoVAC) therapy for the treatment of pharyngocutaneous fistulas. METHODS: In this article, we report on a consecutive case series of six male patients with pharyngocutaneous fistula treated with a modified outside‐in EndoVAC technique. We also present a review of the current related literature. RESULTS: EndoVAC therapy alone was successful in five of the six patients (83.3%) with a median duration of EndoVAC therapy of 18.5 days (range: 7 to 32 days) and a median number of EndoVAC sponge changes of 4 (range: 1 to 9 changes). One patient needed additional reconstructive surgery after prior radiochemotherapy and jejunal transfer. No treatment‐related complications were observed. CONCLUSION: EndoVAC therapy is an easy‐to‐perform, safe procedure for the treatment of pharyngocutaneous fistulae.