Gastro-omental free flap in the reconstruction of the unfavourable hypopharyngeal defects: a functional assessment.

Background: Reconstruction flaps following major head and neck cancer surgery should consider the state of tissue at the recipient site. This study presents the cumulative experience of the use of the gastro-omental free flap (GOFF) for pharyngeal reconstruction in cases with unfavourable recipient site conditions.

Methods: The GOFF reconstruction procedure and postoperative follow-up are described in details, and the functional results are analysed retrospectively.

Results: Fifteen patients underwent GOFF reconstruction. Previous treatments included radiotherapy, chemotherapy and surgery. Postoperatively, two patients (13%) developed partial flap necrosis, and four (27%) patients developed fistula and flap stenosis. On the functional level, eight (53%) patients developed oesophageal speech at different levels of audibility, and all patients developed oral alimentation ranging from a mixed diet with supplements to a regular oral diet.

Conclusions: The GOFF is characterised by multiple survival advantages that favour its use in the presence of inhospitable recipient site conditions.