목적: The incidence of pharyngocutaneous fistula formation reported in the literature is extremely variable, ranging from 5% to 65%. Many risk fators for fistula formation were discussed in other reports and pre- operative nutritional status was one of them. We investigated relationship between the nutritional status of patients and fistula formation after total laryngectomy 방법:A retrospective review of the medical record of the patients who were diagnosed with squamous cell carcinoma( SCC) and underwent total laryngectomy at our institution from 2005 to 2014. We compared pre- operative nutritional status of patients by Nutritional Risk Screening(NRS- 2002), triceps muscle skin thickness, mid-arm circumference, BMI, laboratory examinations between fistula group and no fistula group. 결과:Totally, 48 patients were enrolled to this study and there were 14 cases of pharyngocutaneous fistula after surgery. 10 patients who had total laryngopharyngectomy with flap reconstruction were involved in that fistula group. There was no difference in BMI, laboratory markers including albumin between two groups. Also we could not find significant correlation between NRS score and pharyngocutaneous fistula. But in no-fistula group, patients showed higher value of mid-arm circumference than fistula group(242.8mm vs 214.6mm) with stastical significance( p-value=0.002). Triceps muscle skin thickness showed strong correlation with fistula formation but it did not have stastical significance (p-value=0.07) 결론:Pharygo cutaneous fistula is very troublesome complication after total laryngectomy and many risk factors for the fistula formation were revealed. From our study, we concluded that mid-arm circumference could be used for the simple screening tool for pharyngocutaneous fistula after total laryngectomy and more concerns should be needed when we operate in those patients with risk factors in nutritional aspect.