Fasciocutaneous free flap reconstruction for squamous cell carcinoma of the hypopharynx

Joo, Young Hoon; Sun, Dong‐Il; Cho, Kwang-Jae; Park, Jun‐Ook; Kim, Min‐Sik

doi:10.1007/s00405-010-1367-z

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…Our overall flap failure rate was 12 %, with a slightly higher flap failure rate in the pedicled flap group than the free flap group (13 versus 11 %). When we compare this with other studies, combined flap failure rates varies from 0 to 9.5 % [ 1 , 13 , 17 , 19 – 21 ]. Pedicled pectoralis major often has a failure rate of 0 %, because there is no need for microvascular anastomosis [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 82%

Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation

Brederode

Halmos

Stenekes

2016

Eur Arch Otorhinolaryngol

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The main objective of this study was to evaluate functional outcome in terms of food passage of the three different reconstruction techniques that are currently most often used for hypopharyngeal reconstruction in our institution. A retrospective observational database research was conducted of all patients that underwent hypopharyngeal reconstruction for carcinoma of the hypopharynx or larynx from 1992 until 2014 in the University Medical Center Groningen. The following techniques were most commonly used and therefore analyzed: the pedicled pectoralis major flap, the radial forearm free flap and the anterolateral thigh free flap. Our primary outcome food passage was measured after 1 year and classified in gastric tube fed, fluids, semisolid or solid. Complications were registered according to the Clavien Dindo classification in five different grades. Comorbidity was scored using the Adult Comorbidity Evaluation Index. 58 patients were included. 51 patients survived one year follow up, 25 % returned to a solid diet, 40 % returned to a semi-solid diet and 20 % remained feeding tube dependent. Overall flap success rate was 88 and 35 % developed a pharyngocutaneous fistula. Multivariable ordinal regression showed that reconstruction with free flaps, a near-circumferential surgical defect, a higher body mass index and no comorbidity showed significantly better functional outcomes in the food passage. For recipient site complications, both free flaps and a shorter surgery time resulted in less severe complications. This study shows that the use of free flaps is superior to the use of the pectoralis major flap, and that it should therefore be reserved as a second choice.

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Section: Discussionmentioning

confidence: 82%

Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation

Brederode

Halmos

Stenekes

2016

Eur Arch Otorhinolaryngol

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“…With the development of microsurgical techniques, several fasciocutaneous free flaps from the radial forearm and anterolateral thigh have been widely utilized for the reconstruction of the hypopharynx [4]. Among the many free skin flaps available the radial forearm flap, which was first reported to be used for pharyngoesophageal reconstruction in 1985 [5], is the most popular free flap for head and neck soft tissue reconstruction after tumor extirpation.…”

Section: Introductionmentioning

confidence: 99%

Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma

et al. 2014

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ObjectivesThe aim of this article was to determine outcomes in patients with squamous cell carcinoma of the hypopharynx (SCCHP) in whom the free posterior tibial flap was used for primary reconstruction of hypopharynx defects after cancer resection.Subjects and methodsBetween August 2009 and February 2012, 10 patients with SCCHP underwent posterior tibial flap reconstruction for hypopharynx defects. The corresponding clinical data were retrospectively collected and analyzed.ResultsDespite the multistep and time-consuming procedure, the posterior tibial flap survival rate was 100%. Operation-induced complications did not occur in four patients. Six patients developed postoperative hypoproteinemia, four patients developed postoperative pulmonary infections, and four patients developed pharyngeal fistula. The pharyngeal and laryngeal functions of all patients were preserved.ConclusionOur experience demonstrates that the posterior tibial flap is a safe and reliable choice for the reconstruction of hypopharynx defects.

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“…The results revealed that the average time to achieve oral re-alimentation was 23.0 days postoperatively. [ 22 ] In this study, the average recovery time of eating function in the 2 groups was 17.3 days and 23.1 days, respectively. This meant that the xeno-ADM graft was conducive in restoring eating function, and assists in quickly restoring the postoperative quality of life.…”

Section: Discussionmentioning

confidence: 61%

Comparison of xenogeneic acellular dermal matrix and skin grafts in reconstruction of postoperative defects of hypopharyngeal cancer

Zang

Feng²,

Yang³

et al. 2020

Medicine

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Successful reconstruction after tumor resection facilitates rapid recovery and retention of good quality of life, and this is important for a successful operation. This study aimed to analyze and compare the application and efficacy of xenogeneic acellular dermal matrix (xeno-ADM) and abdominal skin graft in hypopharynx reconstruction. This is a retrospective cohort study that included 25 patients with posterior hypopharyngeal wall cancer who underwent partial hypopharyngectomy with laryngeal preservation. The patients were divided into 2 groups according to the repair materials used. Eleven patients were treated with xeno-ADM, and 14 patients with abdominal skin grafts for repairing hypopharyngeal mucosal defects. The intraoperative data, postoperative recovery time of eating function, graft contraction, infection and pharyngeal fistula rate, and 1-year survival rate of the 2 groups were analyzed and compared. Compared with skin grafts group (23.1 ± 5.8 days), the recovery time of eating function in xeno-ADM group was shorter (17.3 ± 6.4 days), ( P = .026). Also the number of postoperative hospitalization days were less in the xeno-ADM group (18.5 ± 6.7 days) than in the skin grafts group (24.1 ± 5.6 days) ( P = .035). Besides, no significant differences were observed in other comparisons between the 2 groups. Also no obvious rejection and severe graft contraction were observed in both the groups. All patients were successfully decannulated. Both xeno-ADM and abdominal skin grafts demonstrated good effects in the reconstruction of hypopharynx, but the recovery time of eating function in patients with xeno-ADM was faster, which may be due to rapid epithelialization. In addition, it avoids trauma of donor sites.

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Fasciocutaneous free flap reconstruction for squamous cell carcinoma of the hypopharynx

Cited by 9 publications

References 18 publications

Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation

Functional outcome after one-stage flap reconstruction of the hypopharynx following tumor ablation

Free posterior tibial flap reconstruction for hypopharyngeal squamous cell carcinoma

Comparison of xenogeneic acellular dermal matrix and skin grafts in reconstruction of postoperative defects of hypopharyngeal cancer

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