Hyperbaric oxygen therapy for pharyngocutaneous fistula following head and neck surgery: a comprehensive review and our clinical experience

Pharyngocutaneous fistulas (PCF) are a common postoperative complication following head and neck surgery, particularly after total laryngectomy. These types of fistulas represent a challenge for both patients and clinicians due to their persistence and resistance to conventional healing methods. Hyperbaric Oxygen Therapy (HBOT) has been proposed as an adjunctive treatment to enhance healing and closure of PCF. While many studies report positive outcomes, the results are not universally consistent. This comprehensive review aimed to examine the clinical evidence supporting the efficacy of HBOT in the management of pharyngocutaneous fistulas, focusing on fistula closure rates, infection control, and overall healing improvement. All publications without the restriction of time and published in the English language were included. Searches were performed in the PubMed, MEDLINE, Scopus, and Embase databases. Ten articles were included in this review. The evaluation of our clinical experience with this method of treating PCF showed results comparable to those found in the literature and analyzed among the studies reviewed. Several studies indicate that HBOT promotes fistula closure, reduces healing time, and enhances the local immune response, but further investigation is required to optimize protocols and patients’ selections.