Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review

Abstract

Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2317-E2321, 2016.

Complications, hospital length of stay, and readmission after total laryngectomy

“…14,[28][29][30] The use of vascularized tissue reconstruction of the neopharynx, even in an onlay fashion, has greatly reduced the incidence of PCFs and wound complications. 18,[31][32][33] In agreement with this trend, more than two-thirds of the patients in this study underwent reconstruction with regional or free tissue transfer. Considering…”

“…Because of the high morbidity of PCFs, salvage TL represents one of the most common indications within head and neck surgery for regional or free tissue reconstruction . The use of vascularized tissue reconstruction of the neopharynx, even in an onlay fashion, has greatly reduced the incidence of PCFs and wound complications . In agreement with this trend, more than two‐thirds of the patients in this study underwent reconstruction with regional or free tissue transfer.…”

Free Flap Versus Pedicled Flap Reconstruction of Laryngopharyngeal Defects: A 10‐Year National Surgical Quality Improvement Program Analysis

“…PFs can be a good option in patients who are poor candidates for microvascular surgery due to comorbidities. A recent systematic review and meta‐analysis determined that the prophylactic use of a pectoralis flap decreases the incidence of pharyngocutaneous fistula after salvage TL . However, there is no strong consensus in the literature regarding the efficacy of pectoralis flaps, with some studies demonstrating a decreased PCF rate, and others showing no significant benefit in the PCF rate .…”

“…A recent systematic review and meta-analysis determined that the prophylactic use of a pectoralis flap decreases the incidence of pharyngocutaneous fistula after salvage TL. 36 However, there is no strong consensus in the literature regarding the efficacy of pectoralis flaps, with some studies demonstrating a decreased PCF rate, 11,[37][38][39][40][41][42] and others showing no significant benefit in the PCF rate. [43][44][45] There are several advantages to using PFs in TL or TLP reconstruction.…”

The Pectoralis Major Musculocutaneous Flap in Head and Neck Cancer Reconstruction

“…The PMMF has been the workhorse flap for this indication. While some studies show a clear reduction in pharyngocutaneous fistula rates, others suggest that the fistulae that occur are smaller and rarely need repair [13][14][15][16].…”