Integrated Management of Pharyngocutaneous Fistula following Papillary Thyroid Carcinoma Surgery: A Single Case Report

Abstract

A Pharyngocutaneous fistula (PCF) is an abnormal communication between the Pharynx and the skin that allows the leaking of saliva and ingested food particles through an opening in the skin. Its occurrence of a pharyngocutaneous fistula (PCF) after head and neck cancer surgery is a serious complication. Ksharakarma is useful as the substitute of surgical instruments because they can be used safely on the patients who cannot undergo surgery. Kshara possess inherent property to destroy unhealthy tissues. The pharmaceutical and medicinal utility of the Biosalts have interesting and appreciable aspect from applied point of view as the Kshara may liquefy the phlegm and fat and thus clear the body channels, causes necrosis when applied on infected tissue by its caustic action, and thereby promotes wound healing from the base.Here, a 52 year old woman with Pharyngocutaneous Fistula (PCF) over left side of neck, post thyroidectomy status - Papillary Carcinoma of Thyroid since 2 months. She underwent Ksharakarma (Apamarga Tikshna Kshara) followed by twice daily dressing with Jatyadi Taila over the affected part along with oral Ayurveda medication has been given with monitoring of signs and symptoms. The patient got relieved from all previous signs and symptoms like pain, discharge; without any adverse events of treatment. Kshara is a caustic, alkaline in nature obtained from the ashes of medicinal plants known for Vrana Shodhana (purification of wound) and Ropana (healing) properties. Application of Kshara, leads to debridement of the fibrous tissue and at the same time remaining wound will be healed by its scraping and healing property. Because of all these properties of Kshara, it was taken here for managing recurrent Pharyngocutaneous fistula. This treatment was well-tolerated by the patient and is affordable, available treatment for the patient and requires very less hospitalization.