Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.

Enterocytozoon bieneusi is an important microsporidian protozoa that causes intestinal disorders in humans. We collected 191 fecal samples from roadkill deer carcasses, among which 13 (6.8%) showed positive reaction for E. bieneusi by polymerase chain reaction assay. Phylogenetic analysis revealed 6 distinct genotypes, 1 of which was novel. All genotypes belonged to Group 1, which has low host specificity, indicating possible transmission through sylvatic cycle. E. bieneusi infection was predominant in female deer (p<0.05).

Pharyngocutaneous fistula (PCF) is a communication created between the pharynx and skin of the neck associated with flap reconstruction or primary closure of a pharyngeal defect. In patients who underwent laryngectomy and pharyngectomy, salivary accumulation in the deep neck space through the pharyngeal dehiscence can cause life-threatening complications, among which is carotid artery blow-out. Broad-spectrum antibiotics, compressive dressing, and artificial nutrition are usually applied first. Many closing methods have been studied, both surgically (direct repair or using flaps) and non-surgically (negative pressure therapy, hyperbaric oxygen therapy, or botulinum toxin injection). The use of a vacuum-assisted closure system placed endoluminally or externally has been recently reported to treat any leaks in the upper gastrointestinal tract. Here, we report a successfully-treated PCF using the endoluminal vacuum-assisted closure system.

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.

Enterocytozoon bieneusi is an important microsporidian protozoa that causes intestinal disorders in humans. We collected 191 fecal samples from roadkill deer carcasses, among which 13 (6.8%) showed positive reaction for E. bieneusi by polymerase chain reaction assay. Phylogenetic analysis revealed 6 distinct genotypes, 1 of which was novel. All genotypes belonged to Group 1, which has low host specificity, indicating possible transmission through sylvatic cycle. E. bieneusi infection was predominant in female deer (p<0.05).

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.

Enterocytozoon bieneusi is an important microsporidian protozoa that causes intestinal disorders in humans. We collected 191 fecal samples from roadkill deer carcasses, among which 13 (6.8%) showed positive reaction for E. bieneusi by polymerase chain reaction assay. Phylogenetic analysis revealed 6 distinct genotypes, 1 of which was novel. All genotypes belonged to Group 1, which has low host specificity, indicating possible transmission through sylvatic cycle. E. bieneusi infection was predominant in female deer (p<0.05).

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.

Enterocytozoon bieneusi is an important microsporidian protozoa that causes intestinal disorders in humans. We collected 191 fecal samples from roadkill deer carcasses, among which 13 (6.8%) showed positive reaction for E. bieneusi by polymerase chain reaction assay. Phylogenetic analysis revealed 6 distinct genotypes, 1 of which was novel. All genotypes belonged to Group 1, which has low host specificity, indicating possible transmission through sylvatic cycle. E. bieneusi infection was predominant in female deer (p<0.05).

Tracheocutaneous fistula (TCF) formation is a complication of long-term tracheostomy use. Surgical closure is necessary for a persistent TCF because this can lead to various complications. Herein, we describe our use of an island deltopectoral (DP) flap to treat a large TCF. A 62-year-old male, who had previously undergone supraglottic partial laryngectomy with laser and radiation therapy, presented with a second recurrence of supraglottic cancer. Supracricoid partial laryngectomy and cricohyoidoepiglottopexy (CHEP) were performed. Afterward, a large TCF measuring about 2.0×2.5 cm developed. The island DP flap facilitated successful TCF closure. There have been no recurrences or complications, and both the reconstruction site and donor site are well-maintained after 25 months of follow-up. The island DP flap can be a useful option for large TCF closure, even for patients who have had previous radiation therapy.