The application of free anterolateral thigh flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defects
10.3760/cma.j.issn.1673-0860.2015.06.009
- VernacularTitle:带观察窗皮岛设计的游离股前外侧皮瓣修复下咽环形缺损的临床分析
- Author:
Weiwei LIU
1
;
Hanwei PENG
;
Xuekui LIU
;
Zhuming GUO
Author Information
1. 中山大学肿瘤防治中心头颈外科
- Keywords:
Hypopharyngeal neoplasms;
Free tissue flaps;
Reconstructive surgical procedures;
Carcinoma,squamous cell
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2015;50(6):477-481
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.Methods The free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects.The short-term results of reconstructive surgeries and key points,advantages and complications of this technique were summarized.Results The length of circumferential hypopharyngeal defects ranged from 7 to 9 cm.ALT flap with an area of (8-9) cm × (11-18)cm was harvested.A reporter skin island with the skin area of (2.0-3.0) cm× (2.5-4.0) cm was designed.91％ (20/22) of ALT flaps survived.Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap.All the patients had patent anastomotic lumen.Good postoperative subjective swallowing evaluation was obtained in 59％ (13/22) of patients;41％ (9/22)of patients had acceptable swallowing results.Three patients (14％) presented with postoperative pharyngocutaneous fistula.One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.Conclusions The application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable,with satisfying swallowing function and limited trauma.
