Endocrine Abstracts

JOINT3022

Introduction: Diabetes is a major risk factor for the development of pharyngostoma, a severe postoperative complication that significantly impairs healing. Other contributing factors include poor nutritional status, radiotherapy history, and infection, all of which further compromise tissue regeneration and wound closure.

Objective: This study aims to evaluate the impact of diabetes and other associated risk factors on the incidence, progression, and management of pharyngostoma.

Methods: A retrospective analysis was conducted on patients who developed pharyngostoma, comparing diabetic and non-diabetic cases while considering additional risk factors such as malnutrition, prior radiotherapy, and infections. Data on healing time, complication rates, and clinical outcomes were analyzed.

Results: The average age of our patients was 60 years. The sex ratio was 19.5. 95.1% of patients were smokers, and 51.2% were alcoholics. Some patients had associated comorbidities; diabetes was noted in 7.3% of cases, hypertension in 8.9% of cases, heart disease in 0.8%, and chronic obstructive pulmonary disease in 2.4% of cases. Ten (8.1%) patients had a history of laryngeal cancer. In 3 cases (2.4%), partial laryngeal surgery was performed, and in 7 cases (5.7%), initial non-surgical treatment included radiotherapy. Radiotherapy was exclusive in two cases and combined with chemotherapy as part of a laryngeal preservation protocol in the remaining 5 cases. For locoregional and distant staging, all patients underwent panendoscopy and cervical thoracic CT scan. Total laryngectomy was performed in all patients, extended to neighboring structures in 35.8% of cases. Postoperatively, pharyngostoma occurred in 11 (8.9%) of our patients. Univariate analysis found a statistically significant relationship between the occurrence of pharyngostomy and a history of diabetes (P = 0.034), preoperative radiotherapy (P = 0.016), total laryngectomies extended to the hypopharynx (P = 0.017), and postoperative parietal infection (P = 0.000). Preoperative albumin and hemoglobin levels, initial tracheostomy, advanced tumor stage, and suture type were not associated with an increased risk of pharyngostomy in our series.

Conclusion: Diabetes significantly increases the risk of pharyngostoma, particularly when combined with other risk factors. Optimized glycemic control, along with appropriate nutritional support, infection prevention, and careful surgical planning, is essential to improving postoperative outcomes in high-risk patients.