Impact of internal mammary artery perforator propeller flap in neck resurfacing and fistula closure after salvage larynx cancer surgery: Our experience

Abstract

Background Salvage total laryngectomy (TL) and laryngopharyngectomy (LP) after chemoradiotherapy may produce disfiguring defects with severe complications that require complex reconstructions. Methods Between January 2012 and December 2018, we enrolled 25 patients who underwent internal mammary artery perforator (IMAP) flap reconstruction after salvage TL or LP. We performed retrospective review of clinical charts to collect information such as history, timing of reconstruction, type of defect, follow‐up, donor and recipient site complications, and overall flap survival (OFS) rate. Three years overall survival (OS), relapse‐free survival (RFS), and disease‐specific survival (DSS) were calculated. Results The OFS rate was 95%. One partial flap necrosis was recorded. No donor‐site complications were found. The mean follow‐up was 18 months. Three years OS was 44%, RFS was 47%, and DSS was 54%. Conclusions IMAP flap appears to be safe, versatile, and easy to harvest, with minimal donor site morbidity. It is a reliable option in Head&Neck reconstruction, in salvage surgery as well.

Analysis of risk factors for complications of perforator propeller flaps used for soft tissue reconstruction after malignant tumor resection: A systematic review and meta‐analysis

“…A total of 2733 references were identified, and we included 26 studies (Almadori et al, 2019; Almadori et al, 2020; Baghaki et al, 2017; Baltu et al, 2016; Brunetti et al, 2016; Cordova et al, 2014; Cordova et al, 2015; D'Arpa et al, 2009; D'Arpa et al, 2014; Falinower et al, 2020; Gunnarsson et al, 2015; Hage et al, 2018; Han et al, 2018; Ioannidis et al, 2015; Karsidag et al, 2010; Kwon et al, 2021; Liu et al, 2021; Lombardo et al, 2016; Moio et al, 2017; Ordenana et al, 2021; Ruiz‐Moya et al, 2015; Thomsen et al, 2013; Uslu, 2019; Yoon et al, 2013; Yu et al, 2016; Zang et al, 2015) that met our inclusion criteria. Figure 1 showed the study selection through the processes of identification, screening, and eligibility.…”

“Fistula Zero” Project After Total Laryngectomy: The Candiolo Cancer Institute Experience

“…Many authors suggest that reinforcing the pharyngeal suture with wellvascularized tissue will help to reduce the incidence of PCF formation in these patients (5,29,30). The pectoralis major myofascial flap is one of the most reliable flaps, but many other reconstructive options are described (supraclavicular artery island flap, fasciocutaneous free flaps, mammary artery perforator propeller flap, latissimus dorsi flaps, and facial artery-based cutaneous island flap) (21,22,(31)(32)(33)(34).…”

Designing An Anterolateral Thigh Flap Using Ultrasound

“…When planning local perforator flaps, the exact axis of the perforator within the subcutaneous tissue can be delineated, which helps us to precisely include the perforator tree within the flap design. 18…”