Outcomes following pharyngolaryngectomy with fasciocutaneous free flap reconstruction and salivary bypass tube

Authors

  • Fernando López MD, PhD,

    Corresponding author
    1. Department of Otorhinolaryngology and Head and Neck Surgery, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain
    • Álvarez, c/o Marcos Peña Royo, 20–4°A, 33013 Oviedo–Asturias, Spain
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  • Sergio Obeso MD,

    1. Department of Otorhinolaryngology and Head and Neck Surgery, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain
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  • Daniel Camporro MD, PhD,

    1. Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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  • Ángel Fueyo MD,

    1. Department of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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  • Carlos Suárez MD, PhD,

    1. Department of Otorhinolaryngology and Head and Neck Surgery, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain
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  • José L. Llorente MD, PhD

    1. Department of Otorhinolaryngology and Head and Neck Surgery, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, Spain
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Reconstruction of the pharyngoesophageal defects is one of the most challenging for head and neck surgeons. We evaluated our experience in the hypopharyngeal reconstruction using a fasciocutaneous free flap in conjunction with a Montgomery salivary bypass tube (MSBT).

Study design:

Retrospective review.

Methods:

The charts of 55 patients who had undergone hypopharynx reconstruction using either a radial forearm free flap (RFFF) (24) or an anterolateral thigh (ALT) flap (31) with MSBT were reviewed. There were 40 circumferential and 15 near-circumferential defects. Outcomes analyzed included fistula and stricture rates and swallowing function.

Results:

Pharyngocutaneous fistula occurred in 9% of patients (16% using RFFF and 3% using ALT), and strictures occurred in 5% (8% using RFFF and 3% using ALT). Of patients reconstructed with this technique, 95% were able to resume oral alimentation.

Conclusions:

The use of fasciocutaneous free flaps in conjunction with the MSBT is a useful tool for pharyngoesophageal reconstruction. Laryngoscope, 2013

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