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#57496 12-01-2005 03:05 PM
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I think I've spelled it correctly. Has anyone else experienced a fistula after surgery and radiation? If so how did you get the situation corrected? I had one develope that drains from the site of my tumor at the base of my tongue and exits on my chin. My ENT says it's best if it heals on it's own. We've discussed surgery to remedy the situation, but I'm trying to be patient and allow it to heal by itself. Any thoughts out there?

John


SCC base of tongue. Diagnosed as stage IV, Sept. '04. Partial glossectomy, Radical neck dissection left side, 37 Radiation sessions, Chemo x 7 weeks. Finished treatments January '05. Cancer surivor!
#57497 12-01-2005 05:31 PM
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Hello John, these happen often enough for us to have heard about them. (I did not personally have one). The best description in lay terms is that the healing process needs to find a path for fluid to drain out. Because the normal flow of lymph has been disrupted by the treatments, the fistula forms. They can also be the result of infection. Over time they usually heal by themselves. I am not a medical expert, but it would seem to me that if it is still draining then surgery to close it would mean nature would try to open a path again.

Take care


Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.
#57498 12-01-2005 07:23 PM
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The important point here is that it has been definitivly determined that this is not from an infection or the drainage of other necrotic debris. Everyone that has had neck surgeries knows that for serval days after a surgery they will put in drains so that the excess body fluids have a pathway out of the area. These are finally removed when sufficient drainage has taken place. Fistulas are usually allowed to drain, and the wound area should be kept really clean. Irrigate it daily with saline, if it is messy tape some gauze over it. If it smells bad, or the discharge from it seems excessive to you, or it dosen't resove in a short period of time and begin to heal, get your doctor to reevaluate the situation. If you begin to run a temperature, tell him right away.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
#57499 12-02-2005 02:37 AM
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Mark and Brian,

Thanks for the reply. That's pretty much verbatim what my ENT told me. I keep a dressing on it and change it on a regular basis. Most of the drainage occurs after a meal or after drinking. There are certain ways that I can move what's remaining of my tongue and I can force fluid out of it. The original site of the fistula healed once and as luck would have it, it found an alternate drain site. I will explore my options with my ENT on my next follow up visit, which is in January. Proud to say that I've graduated from once per month visits to every three months! Slowly but surely, life is getting back to normal. A fistula is small potatoes compared to what I've experienced. At least for me. I'm glad I found this site. You guys provide an awesome service to oral cancer patients. Thanks for your reply's and keep up the good work.
John


SCC base of tongue. Diagnosed as stage IV, Sept. '04. Partial glossectomy, Radical neck dissection left side, 37 Radiation sessions, Chemo x 7 weeks. Finished treatments January '05. Cancer surivor!
#57500 12-02-2005 03:15 AM
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John,

I'm not intellectually prepared to argue this point, but that sounds like an issue that may require some followup work. While a fistula can be a leak, I don't think it is a good idea for you to wait for the flesh to fuse together. I had a minor fistula, but it was a draining wound. It was opened and allowed to heal from the inside out. It sounds like you have an actual opening that should be looked at. You know, closed on the inside. Just a thought.

Glenn

#57501 12-02-2005 03:32 AM
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John, In view of your later comments, it would seem that Glenn's point is good. If this is an opening that could allow food to enter from the inside I would think that closing that off (on the inside) would be better. If it were me I would not wait until January. The prospect of some funky infection from food getting caught and not draining out would bother me.

Take care


Mark, 21 Year survivor, SCC right tonsil, 3 nodes positive, one with extra-capsular spread. I never asked what stage (would have scared me anyway) Right side tonsillectomy, radical neck dissection right side, maximum radiation to both sides, no chemo, no PEG, age 40 when diagnosed.
#57502 12-03-2005 12:21 PM
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I've had it looked at on several different occasions. My ENT/Otolaryngologist will be in the operating room in a few weeks when I have some surgery done by an oral surgeon and a dentist. I'm going in to have some teeth removed and a bridge made. I have to have it done while I'm out since they have to pry my mouth open. I have some real issues with opening my mouth. Your advice is right on. Some days the drainage is less than others. There are times where it doesn't drain for days at a time. My ENT/Otolaryngologist would really prefer that it heal on it's own. The way that he explained the procedure to me to have it corrected is somewhat similar to the original surgery that I had. Never had the darn thing unitl after the radiation. I guess radiation is the gift that keeps on giving. Thanks for all of your replies and information on this guys.

John


SCC base of tongue. Diagnosed as stage IV, Sept. '04. Partial glossectomy, Radical neck dissection left side, 37 Radiation sessions, Chemo x 7 weeks. Finished treatments January '05. Cancer surivor!

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