151751-Najiba-Chargi

158 CHAPTER 9 ABSTRACT Background The occurrence of a pharyngocutaneous fistula after laryngectomy is a common and difficult to treat complication, resulting in significant morbidity and decreased quality of life after lar - yngectomy. Recent studies showed that arterial calcification is associated with postoperative wound complications in patients with oesophageal cancer. Material and methods In this study, we investigated the association between arterial calcification and the occur- rence of a pharyngocutaneous fistula. A monocenter retrospective cohort study of patients undergoing laryngectomy between 2008 and 2017. A tertiary referral center for head and neck oncology in the Netherlands.All patients undergoing laryngectomy for any indication were included in this retrospective cohort study. Diagnostic CT-images were scored blinded for the outcome for the presence and severity of arterial calcification on 10 different locations as absent, mild, moderate or severe (cumulative burden maximal 30 points). The association with pharyngocutaneous fistula was investigated using univariable and multivariable logistic regression analysis. Results In total 224 patients were included for analysis of whom 62 (27.7%) developed a pharyngo - cutaneous fistula. Only 1.3% of patients had no arterial calcification and 7.1% had at most mild arterial calcifications present, of whomonly 1 experienced a pharyngocutaneous fistula. Moderate to severe arterial calcification of the descending aorta, origo of the brachiocephalic arteries and left carotid siphon were significantly associated with developing a pharyngocu - taneous fistula in univariable and multivariable regression analysis (adjusted OR 2.07 - 2.83; all p<0.05). A higher cumulative calcification score was significantly associated with pharyn - gocutaneous fistula formation (adjusted OR 1.06-1.08; p<0.05). Conclusions The presence of arterial calcification is widespread in patients undergoing laryngectomy and its burden is associated with developing pharyngocutaneous fistula. Extensive arterial calci - fication on preoperative CT imaging may be taken into consideration as a preoperative risk factor for pharyngocutaneous fistula in patients undergoing laryngectomy.