Use of a folded extended vertical lower trapezius island myocutaneous flap to repair large pharyngocutaneous fistulae developing after salvage total laryngectomy

The purpose of this study was to evaluate the outcomes of surgery involving the use of folded trapezius flaps to repair large pharyngocutaneous fistulae (PCFs) developing after salvage total laryngectomy. Folded extended vertical lower trapezius island myocutaneous flaps (TIMFs) were created to repa...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2018-10, Vol.47 (10), p.1268-1273
Main Authors: Huang, Z.-q., Zhou, B., Chen, W.-l., Zhong, J.-l., Wang, Y.
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Squamous Cell - surgery
cutaneous fistula
Cutaneous Fistula - etiology
Cutaneous Fistula - surgery
Dentistry
Female
Humans
laryngeal neoplasms
Laryngeal Neoplasms - surgery
Laryngectomy
Male
Middle Aged
Myocutaneous Flap
Pharyngeal Diseases - etiology
Pharyngeal Diseases - surgery
pharyngocutaneous fistula
Postoperative Complications - etiology
Postoperative Complications - surgery
Salvage Therapy - methods
Superficial Back Muscles - transplantation
transverse cervical vessels
trapezius flap
Treatment Outcome
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Summary:The purpose of this study was to evaluate the outcomes of surgery involving the use of folded trapezius flaps to repair large pharyngocutaneous fistulae (PCFs) developing after salvage total laryngectomy. Folded extended vertical lower trapezius island myocutaneous flaps (TIMFs) were created to repair large PCFs that developed after salvage total laryngectomy in eight patients. The maximum fistula dimension was 4.5×3.0cm and the minimum was 2.0×1.8cm. The skin paddle of the extended vertical TIMF ranged from 5cm to 9cm in width and 10cm to 23cm in length. The inner lining ranged from 3cm×3cm to 6cm×6cm in dimension and the outer lining from 6cm×5cm to 16cm×9cm. The folded flaps provided both inner mucosa and outer lining. All flaps survived. No fistula recurrence or stricture developed. After 6–24months of follow-up, six patients showed no evidence of disease, one was alive with disease, and one had died of local recurrence at 20months. The folded flap was very reliable and is well-suited for repairing large PCFs, even early large PCFs and those featuring carotid artery rupture.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2018.05.019