Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

Murray, Dylan J.; Gilbert, Ralph W.; Veselý, Martin; Novak, Christine B.; Zaitlin-Gencher, Sheryl; Clark, Jonathan R.; Gullane, Patrick; Neligan, Peter C.

doi:10.1002/hed.20489

Cited by 87 publications

(92 citation statements)

References 46 publications

(43 reference statements)

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“…6,7 A lethal MSBT-associated fistula from a retroesophageal subclavian artery has also been described. 8 In a review of patients who underwent fasciocutaneous reconstruction of circumferential pharyngoesophageal defects using an anterolateral thigh flap wrapped around an MSBT that was sutured to the tongue base, Murray et al 2 reported MSBT migration into the stomach in 2 of 14 patients. Based on these findings, the authors subsequently sutured the MSBT to a nasogastric tube, which was sutured to the nasal septum.…”

Section: Discussionmentioning

confidence: 99%

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Stent migration to the ileum—A potentially lethal complication after montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy

et al. 2011

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Section: Discussionmentioning

confidence: 99%

“…1,2 When used for tracheoesophageal fistulae, it prevents aspiration, and when used for hypopharyngeal and esophageal stenoses (eg, due to advanced local tumor growth), it enables oral nutrition.…”

mentioning

confidence: 99%

Stent migration to the ileum—A potentially lethal complication after montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy

et al. 2011

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“…Unfortunately, the tube is not indicated for the long-term use in TEF/TPF. Moreover, several complications like fatal stent migration into the ileum [4] and stomach [20] and subclavian arteryesophageal [13] as well as aorto-esophageal [17] fistulas have been reported. Apart from these, many patients reported certain discomfort when swallowing due to the rigid edges of the stent either at the oral or aboral end.…”

Section: Introductionmentioning

confidence: 98%

“…The tube serves as a good tool to avoid post-surgical fistulas or support the closure of small TEF/TPF [20,26]. Unfortunately, the tube is not indicated for the long-term use in TEF/TPF.…”

Section: Introductionmentioning

confidence: 98%

Treatment of large pharyngotracheal fistulas after laryngectomy by a novel customized pharyngeal stent

Herzog

Greiner

2011

Eur Arch Otorhinolaryngol

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Persisting tracheoesophageal (TEF) and/or tracheopharyngeal (TPF) fistulas after laryngectomy are incessant problems that can lead to a tremendous loss of quality of life among patients. As soon as surgical options for closing fistulas become impractical, then alternative approaches to stent the fistulas gain significant value. Conventional stents seldom seal the entire fistula, might dislocate and tend to induce tissue proliferation and cause discomfort to the patient. On the basis of these side effects a novel customized pharyngeal stent has been developed to completely seal the fistula without dislocation and discomfort. The anatomic dimensions of the neopharynx in two patients were obtained by a silicone cast of the respective neopharynx and the stent was manufactured according to this anatomical model. The soft silicone edges of the stent match the pharyngeal anatomic structures and follow the changes of the base of the tongue during the process of swallowing. Nevertheless, the stents are rigid enough to remain in place. The reported two patients were able to subsist by themselves orally most of the time without any signs of leakage at all. One stent had to be explanted after 7 months due to an enlargement of the fistula. The second stent is still in place for 10 months up to now without any side effects.

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“…There are several conservative approaches that support the closure of the fistulas [16][17][18]. However, commercial rigid silicone stents and flexible self-expandable [19] stents are not suitable for long-term applications or short-term use for temporary dilation of stenoses.…”

Section: Introductionmentioning

confidence: 99%

Treatment of tracheopharyngeal and tracheo-oesophageal fistulas following laryngectomy and fistula classification based on individual silicone casts

Herzog

Lorenz²,

Glien

et al. 2014

Eur Arch Otorhinolaryngol

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Persistent tracheopharyngeal (TPF) and tracheo-oesophageal (TEF) fistulas after laryngectomy create a therapeutic challenge. The current classification of TPFs and TEFs is based on clinical experience without detailed anatomical information. In this study, casts of TPFs/TEFs were obtained from 16 patients; these were the first steps in manufacturing customised prostheses. Fistulas were classified according to the shape and dimension of the tracheopharyngeal and tracheo-oesophageal silicone casts and prostheses as well as on epithetic requirements. Four different types of fistulas were classified: Type A, a fistula with a straight axis between the neopharynx and oesophagus; Type B, a fistula with a stenosis of the neopharynx but a straight axis; Type C, the axis between the neopharynx and oesophagus is flexed anteriorly; and Type D, neighbouring structures are absent creating a large defect. This classification system might improve the manufacturing processes of customised prostheses in individual cases with challenging tracheopharyngeal and tracheo-oesophageal fistulas.

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Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

Abstract: The low complication rates and the excellent functional outcomes make the anterolateral thigh flap in combination with a salivary bypass tube a viable option for reconstruction of these difficult defects.

Cited by 87 publications

References 46 publications

Stent migration to the ileum—A potentially lethal complication after montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy

Stent migration to the ileum—A potentially lethal complication after montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy

Treatment of large pharyngotracheal fistulas after laryngectomy by a novel customized pharyngeal stent

Treatment of tracheopharyngeal and tracheo-oesophageal fistulas following laryngectomy and fistula classification based on individual silicone casts

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