Delayed platysma myocutaneous turnover flap for repair of pharyngocutaneous fistula

Neubauer, Paul; Canadas, Karina; Sasaki, Clarence T.

doi:10.1016/j.amjoto.2014.08.015

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…The use of delayed platysma myocutaneous turnover flap was described by Neubauer et al 42 Turnover flaps have been firstly used in the lower extremities to close wounds. They were recently utilized for repair of two PCFs after STL.…”

Section: Delayed Platysma Myocutaneous Turnover Flapmentioning

confidence: 99%

<p>Optimal Management of Post-Laryngectomy Pharyngo-Cutaneous Fistula</p>

Molteni¹,

Sacchetto²,

Sacchetto³

et al. 2020

OAS

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The pharyngocutaneous fistula (PCF) is one of the most common post-operative complications in patients undergoing laryngectomy. Up till now, there is no universally accepted algorithm for managing of PCFs and several treatment modalities are used for wound healing. The English language literature was searched using PUBMED databases with the keywords "laryngectomy", "pharyngocutaneous", "fistula", "treatment", and "management" from January 1, 1999 to June 1, 2019; we selected 35 studies according to inclusion criteria and we conducted a systematic review of the articles. The analysis of the international literature shows a high variability of treatment approaches; there is no consensus about conservative treatment and waiting time, and neither about the indication for surgical treatment or the ideal surgical technique. A first attempt of a conservative measure is mandatory in all cases of PCF. In case of failure of conservative measures surgical treatment should be considered: direct closure and local flap are suitable for small defects, pedicled or free flaps showed good to excellent results in closure of large and complex cervical defects. Other non-invasive treatment such as hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT) showed promising results but in limited case series. Keywords: laryngectomy, pharyngo-cutaneous fistula, reconstructive surgery, hyperbaric oxygen therapy, negative pressure wound therapy, laryngeal cancer 14.3% for primary total laryngectomy (PTL) and 27.6% for salvage total laryngectomy (STL), according to the most recent meta-analysis published in the international literature. 1 Several risk factors have been analyzed in order to understand the etiology of this major complication: previous radiotherapy (RT) or chemoradiotherapy (CHT), type of surgery, T and N stage, a short interval between the end of RT and laryngectomy, hemoglobin levels lower than 125 g/L preoperative as well as postoperative, comorbidities such as diabetes, liver diseases or hypothyroidism, and surgical aspects such as neck dissection, previous tracheotomy, surgical wound infection, resection of the pharynx and its closure after laryngectomy, or the use of non-irradiated tissue to reinforce the pharyngeal suture. [2][3][4][5] The treatment of PCF is crucial in patients who underwent laryngectomy; the persistence of this abnormal communication is associated with delay in adjuvant treatment, prolonged hospital stay, requirement for reoperation, and mortality from, for example, carotid blowout or aspiration pneumonia. The increased incidence of post-laryngectomy PCF in the modern era of organ preservation therapy has driven considerable efforts to develop

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Section: Delayed Platysma Myocutaneous Turnover Flapmentioning

confidence: 99%

<p>Optimal Management of Post-Laryngectomy Pharyngo-Cutaneous Fistula</p>

Molteni¹,

Sacchetto²,

Sacchetto³

et al. 2020

OAS

View full text Add to dashboard Cite

show abstract

“…Most frequent application of these flaps are: defects of the lower limbs and hands, sacral sores, myelomeningocele, chest wall defect, tracheostomy, fistulas of the pharynx and oral cavity and nasal defects (8)(9)(10)(11).…”

Section: Application Of Alternative Reconstructive Surgical Methods Imentioning

confidence: 99%

“…), the affected skin and soft tissue area is usually damaged by irradiation, scabby and has deteriorated circulation. In the literature several methods have been described for the surgical treatment of fistulas: from fasciocutaneous island flaps through local and distant skin-and musculocutaneous flaps up to free microvascular flaps (4,6,8,43). In spite of all these methods, the recurrence of the fistula is rather high, in case of PM musculocutaneous flaps it can be 35% -which may suspect even local tumor recurrence (43).…”

Section: 121turnover Flapmentioning

confidence: 99%

“…nasogastric feeding tube or percutaneous gastrostomy). Direct relation between the preoperative radiotherapy and the development of fistulas have been proved by several publications (8,43); furthermore, age, nutritive status, wound superinfection and tumor stage are additive predisposing factors (43). Despite the relatively high frequency of fistula occurrence, its surgical treatment is a difficult and challenging issue.…”

Section: 121turnover Flapmentioning

confidence: 99%

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