PMC3653163_01
Persistent pharyngocutaneous fistula following 8 months of conservative therapy.
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F1
The postoperative course was complicated by a pharyngocutaneous fistula at the superior margin of the permanent tracheostoma (Fig 1).
Intraoperative fat grafting to fistula margin.
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F2
Approximately 8 mL of purified fat were injected into the area immediately surrounding the pharyngocutaneous fistula using both blunt cannulas and 18 gauge needles (Fig 2).
Size reduction of pharyngocutaneous fistula 3 months following first fat grafting.
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F3
After 3 months of conservative measures (ongoing gastrostomy tube feeds and local wound care), the fistula size reduced by approximately 70% (Fig 3).
Complete fistula closure 4 months after first fat grafting (includes a second procedure of fat grafting).
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F4
It has remained closed 1 year later with the patient tolerating a regular diet (Fig 4).