Objectives/hypothesis: The reconstruction of hypopharyngeal defects should focus on minimizing morbidity in a high-risk population while achieving adequate functional results with regard to the restoration of speech, swallowing, and airway control. We introduce the clinical application of the thoracoacromial artery perforator (TAAP) flap as a new reconstructive option for hypopharyngeal defects.
Methods: This method was used to restore oncologic hypopharyngeal defects in nine patients: three who had previous irradiation and surgery, one who had previous surgery only, and another who had previous radiotherapy only.
Results: All of the TAAP flaps of our series were transferred successfully and survived entirely. The donor sites were closed primarily in all cases. No fistulas, stenosis/strictures, dehiscence, or swelling occurred. Pectoralis major muscle function was completely preserved in all patients.
Conclusions: The use of TAAP flap to reconstruct hypopharyngeal defect is a simple and effective method that does not require microsurgical skills. The flap is thin and pliable, with a reliable blood supply.
Level Of Evidence: 4. Laryngoscope, 126:1315-1320, 2016.
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http://dx.doi.org/10.1002/lary.25675 | DOI Listing |
Microsurgery
October 2024
Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background: Current consensus has established the internal mammary vessels (IMV) over the thoracodorsal vessels (TDV) as the preferred recipients for microvascular breast reconstruction due to their superior flow rates and long-established outcomes. Yet, there are occurrences where the IMVs are not reliable and may subsequently prompt intraoperative decision-making. Several options exist, including the contralateral IMVs, thoracoacromial vessels, and TDVs.
View Article and Find Full Text PDFCureus
August 2024
Anatomy, School of Medicine, Keele University, Keele, GBR.
Med Ultrason
June 2024
Department of Ultrasound Medicine, Yuhuangding Hospital, Yantai, China.
Ann Plast Surg
May 2024
Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Wakayama.
We have recently shown that including the blood flow from the lateral thoracic artery (LTA) in addition to the thoracoacromial artery in the pectoralis major muscle musculocutaneous (PMMC) flap (bipedicle PMMC flap) can increase the perfusion of the flap. We also developed the concept of the supercharged PMMC flap, in which the LTA included in the flap was once cut and anastomosed to a cervical artery under a microscope. It is an effective solution to maintain the additional blood flow from the LTA, when the length of the LTA is compromised for reconstruction.
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