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57891

Hypopharyngeal reconstruction using pectoralis major myocutaneous flap after total hypopharyngolaryngectomy

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Last updated: 24 Dec 2024

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Abstract

Introduction: Pharyngoeoesophageal defect after resection of hypopharyngeal carcinoma is usually reconstructed with gastric pull-up or free vascularized flap either jejunum or radial forearm. OBJECTIVE: The aim is to assess the use of pectoralis major myocutaneous flap (PMMCF) sutured directly to the prevertebral fascia for reconstruction of hypopharyngeal defect following total hypopharyngolaryngectomy. Material and Methods: Total hypopharyngolaryngectomy, total thyroidectomy, partial oesophagectomy and with or without neck dissections were performed for ten patients (seven females and three males) with hypopharyngeal cancer. The defects were reconstructed with PMMCF. The skin island was sutured to the prevertebral fascia.  The main outcome measures included: durations of tube feeding, and hospital stay, character of diet and speech, persistent pharyngocutaneous fistula, recipient and donor site morbidity, tumor recurrence and mortality. Results: In seven out of ten patients, the duration of hospital stay ranged between 10–42 days while that of nasogastric tube feeding was 20 – 42days. In the 8th patient pharyngotracheal fistula had occurred and failed to heal conservatively, surgical closure was done in association with secondary radical neck dissection. In the 9th patient persistent pharyngocutaneous fistula was reported and the patient was diverted for feeding gastrostomy. She died during the course ofchemoradiotherapy for a recurrent tumor. In the 10th patient the healing attempts were poor and wound dehiscence was occurred and the patient died because of carotid blowout. One patient developed seroma at the donor site. Conclusion: The use of PMMCF and suturing it to the prevertebral fascia, gives a simple and time-saving method of reconstruction of the pharynx after total hypopharyngolaryngectomy with acceptable results.

DOI

10.21608/ejnso.2018.57891

Keywords

Hypopharyngeal cancer, Hypopharyngolaryngectomy, Pharyngeal reconstruction, Pectoralis major myocutaneous flap

Authors

First Name

A.R

Last Name

Abdel Hakeema

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Orcid

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First Name

E.M

Last Name

Saleha

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Affiliation

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First Name

T.A.

Last Name

El Gammal

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Orcid

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First Name

A.K.

Last Name

Abdel Haleema

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Orcid

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First Name

M.M.

Last Name

Roushdy

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First Name

M.O.

Last Name

Gad

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Volume

4

Article Issue

1

Related Issue

8775

Issue Date

2018-06-01

Receive Date

2017-12-19

Publish Date

2018-06-01

Page Start

19

Page End

28

Print ISSN

2314-890X

Online ISSN

2314-8918

Link

https://ejnso.journals.ekb.eg/article_57891.html

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https://ejnso.journals.ekb.eg/service?article_code=57891

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Journal

Publication Title

Egyptian Journal of Neck Surgery and Otorhinolaryngology

Publication Link

https://ejnso.journals.ekb.eg/

MainTitle

Hypopharyngeal reconstruction using pectoralis major myocutaneous flap after total hypopharyngolaryngectomy

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Article

Created At

22 Jan 2023