{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:28:55Z","timestamp":1783020535362,"version":"3.54.6"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of contrast swallow utilised to identify pharyngocutaneous fistula (PCF) following laryngectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>A systematic search of databases was conducted (MEDLINE, EMBASE, and PubMed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Studies including adult patients (\u226518 years old) who had undergone total laryngectomy (salvage or primary) or pharyngolaryngectomy and had postoperative diagnostic imaging of any modality (eg, ultrasound, CT, MRI) performed to assess for presence of PCF were eligible for inclusion. The diagnostic accuracy (ie sensitivity, specificity, etc.) for identifying PCF was extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 13 studies involving 1456 patients recruited across a 43\u2010year period from (1979 to 2022) were included. Diagnostic accuracy ranges of contrast swallow were reported as a sensitivity of 0.26 to 1.00, specificity of 0.55 to 0.99 and positive and negative predictive values of 0.14 to 0.85 and 0.75 to 1.00 respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The accuracy of contrast swallow as a screening tool in detecting PCF varies significantly in the reported studies with overall poor performance. Studies displayed a varied positive predictive value range, with a high number of false positives potentially causing unwarranted delays in commencing oral feeding. Positive predictive values must be interpreted cautiously given the literatures variation of how pharyngeal leaks were managed, potentially preventing progression to clinical PCF. While the heterogenicity within the data from the studies prevents definitive conclusions, the review calls into question the utility of the contrast swallow and highlights the need for more superior diagnostic pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70251","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:07:56Z","timestamp":1777896476000},"page":"39-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contrast Swallow for Detecting Pharyngocutaneous Fistula After Total Laryngectomy: A Systematic Review"],"prefix":"10.1002","volume":"175","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0325-9697","authenticated-orcid":false,"given":"Matthew E.","family":"Ryan","sequence":"first","affiliation":[{"name":"Liverpool Head &amp; Neck Centre Liverpool University Hospitals NHS Foundation Trust Liverpool L9 7AL UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1311-0335","authenticated-orcid":false,"given":"Kristijonas","family":"Milinis","sequence":"additional","affiliation":[{"name":"Liverpool Head &amp; Neck Centre Liverpool University Hospitals NHS Foundation Trust Liverpool L9 7AL UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ahamed","sequence":"additional","affiliation":[{"name":"School of Medicine Faculty of Health and Life Sciences, University of Liverpool Liverpool L69 3GE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheema I.","family":"Sidat","sequence":"additional","affiliation":[{"name":"School of Medicine Faculty of Health and Life Sciences, University of Liverpool Liverpool L69 3GE UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7963-1224","authenticated-orcid":false,"given":"Jason C.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Liverpool Head &amp; Neck Centre Liverpool University Hospitals NHS Foundation Trust Liverpool L9 7AL UK"},{"name":"Department of Molecular and Clinical Cancer Medicine Faculty of Health and Life Sciences, University of Liverpool Liverpool L69 7TX UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1482.16092"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.1.67"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24549"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05718-9"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-003-0643-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23591"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26429"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.112"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2016.01.004"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215114000747"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08016-7"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.24983\/scitemed.aohns.2020.00133"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27617"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199904010-00010"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25302"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988409200104"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12051851"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989210600310"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199310000-00014"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120000596"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1102\/1470-7330.2007.0015"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23443"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-019-0799-x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949009900703"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.123.2.307"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiographics.20.3.g00ma01673"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0455.2000.041005482.x"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2021.08.001"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181c1aeb8"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/30515892"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-012-9424-y"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.427"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25617"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.110617"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24248"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70251","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70251","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:05:12Z","timestamp":1783015512000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/ohn.70251"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70251","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]},"assertion":[{"value":"2025-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}