Management of Cervical Tracheo-Esophageal Fistula by Lateral Cervical Approach: Our Experience'

Acquired Tracheo-esophageal fistula (TEF) is a challenging and complicated condition. The laryngeal protection is lost in acquired TEF cases due to the established connection between the esophagus and the airways leading to aspiration, pneumonia, and acute respiratory distress syndrome. Malignancy contributes to about 80% of acquired TEF. Nonmalignant causes for TEF include prolonged ventilation, trauma (iatrogenic, penetrating, or blunt injury), foreign bodies, corrosive burns, and granulomatous infections. With the advancements in critical care, the incidence of TEF post-ventilation is on the rise in recent decades. We would like to share our experience managing ten cases of nonmalignant acquired cervical TEF by the lateral cervical approach at our institute. Apart from the isolated TEF cases, one patient with concomitant tracheal stenosis was repaired simultaneously with good postoperative results. TEF was identified in two cases following removal of T-tube and solid stent respectively and was repaired successfully with lateral cervical approach with strap muscle flap interposition.

Automated summary

Acquired tracheo-esophageal fistula (TEF) is a challenging condition characterized by loss of laryngeal protection and potential respiratory complications. While malignancy is the leading cause of TEF, nonmalignant causes such as prolonged ventilation, trauma, and foreign bodies also contribute to its development. Techniques like lateral cervical approach have been successful in managing TEF cases, even in patients with additional airway complications.