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Pharyngocutaneous fistula caused by dried ‘Kombu’ (edible seaweed) after total laryngectomy
  1. Yuki Kusaba1,2,
  2. Toru Miwa1,3,
  3. Momoko Ise1 and
  4. Ryosei Minoda3
  1. 1 Department of Otolaryngology - Head and Neck Surgery, Kumamoto University, Kumamoto, Japan
  2. 2 Department of Otolaryngology- Head and Neck Surgery, Kumamoto Rosai Hospital, Yatsushiro, Japan
  3. 3 Otolaryngology - Head and Neck Surgery, JCHO Kumamoto General Hospital, Yatsushiro, Japan
  1. Correspondence to Dr Toru Miwa, miw.com1101{at}


The most common early complication after total laryngectomy is pharyngocutaneous fistula (PCF). However, there are no reports of PCF after total laryngectomy caused by ‘Kombu’ (edible seaweed) as a foreign body in the digestive tract. A 68-year-old Japanese man had undergone total laryngectomy 5 years previously. He presented with PCF, neck swelling and pain. Video endoscopy showed that a dark green foreign body obstructed the digestive tract. PCF was successfully treated via emergency surgery comprising abscess drainage, foreign body removal and fistula closure. The foreign body was kombu. Clinicians who perform total laryngectomy should know the potential dangers of consuming hygroscopic food items that can cause bolus obstruction of the upper digestive tract and pharyngeal abscess and perforation.

  • rehabilitation medicine
  • head and neck cancer
  • nutritional support

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  • YK and TM contributed equally.

  • Contributors YK and TM contributed equally to this paper. YK and MI analysed and interpreted the patient data regarding the obstructed digestive tract and pharyngocutaneous fistula. TM and RM advised and managed this paper. Each author had responsibilities in the production of this paper. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.