Reconstruction of total circumferential pharyngeal defects following caustic or stenosant lesions of the pharynx present major challenges with respect to minimizing surgical morbidity and restoring functional deficits. With recent advances in microvascular free tissue transfer, the options for pharyngeal reconstruction have multiplied in order to maximize swallowing and voice. There is long experience in the reconstruction of the pharynx and the cervical esophagus in oncological patients after total pharyngolaryngectomy, but there are not many publications concerning circumferential pharyngeal reconstruction preserving the larynx. Here, we discuss 2 new techniques for total circumferential pharyngeal reconstruction respecting swallowing and voice by means of extra-anatomical bypasses (visceral or fasciocutaneous), upholding the larynx in its original placement.
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http://dx.doi.org/10.1097/GOX.0000000000002008 | DOI Listing |
Clin Exp Otorhinolaryngol
November 2024
Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Objectives: A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique was developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time.
Methods: Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled.
Microsurgery
November 2024
Department of Plastic and Reconstructive Surgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
J Craniofac Surg
January 2025
Department of Plastic and Reconstructive, Aesthetic Surgery, Toyama University Hospital, Toyama, Japan.
The patient was a 71-year-old male with hypopharyngeal carcinoma who underwent right-sided neck dissection for lymph node metastasis, adjuvant radiotherapy (70 Gy), and cisplatin chemotherapy, he developed neck inflammation with evidence of free air on computed tomography and subcutaneous fistula formation on laryngoscopy. After total laryngectomy, bilateral neck vessels were obscured by scar tissue secondary to radiotherapy and chronic inflammation. Pedicled pectoralis major (PM) flap was favored for reconstruction.
View Article and Find Full Text PDFHead Neck
December 2024
Department of Plastic & Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Background: Few studies have examined health-related quality of life (HRQOL) outcomes in long-term total laryngectomy survivors in relation to the type of hypopharyngeal defect.
Methods: A cross-sectional study was performed in long-term total laryngectomy survivors, treated between 2000 and 2020. The primary outcome was HRQOL, assessed using the FACE-Q Head and Neck Cancer Module, in relation to the type of hypopharyngeal closure (primary closure, partial or circumferential reconstruction).
Zhonghua Yi Xue Za Zhi
July 2024
Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Jinan 250023, China.
To investigate the pathological characteristics of tumor regression and the expression level of chemoradiotherapy resistance-related molecular markers after preoperative concurrent radiochemotherapy in patients with locally advanced hypopharyngeal carcinoma. The clinical data of 44 patients with locally advanced hypopharyngeal carcinoma who underwent preoperative concurrent radiochemotherapy in the Department of Head and Neck Surgery of Shandong Otolaryngology Hospital from August 2016 to August 2020 were retrospectively analyzed. All patients received preoperative concurrent chemotherapy and radiotherapy.
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