Reconstruction of laryngopharyngectomy defects: Comparison between the supraclavicular artery island flap, the radial forearm flap, and the anterolateral thigh flap

Reiter, M.; Baumeister, Philipp

doi:10.1002/micr.30406

Cited by 30 publications

(37 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Microsurgical free tissue transfer procedures represent nowadays one of the best solutions to reconstruct defects in the head and neck region (Xu et al, 2011). Today, many options in the free flaps field are available: among the most known ones there are the anterolateral thigh (ALT) flap, the superficial circumflex iliac artery perforator (SCIP) flap (Choi, Kim, Oh, Koh, & Jeong, 2017), the medial sural artery perforator (MSAP) flap, the ulnar artery perforator (UAP) flap (Huang et al, 2012), the RFFF, and the supraclavicular artery island flap (SCAIF), which proved to be an equivalent alternative to ALT and RFFF in expert hands (Reiter & Baumeister, 2019). In the era of perforator flaps, the ALT flap and, more recently, the SCIP flap are considered to be the standard ones for reconstructions throughout the body, followed by the MSAP flap.…”

Section: Discussionmentioning

confidence: 99%

Free double‐paddle posterior tibial artery perforator flap for hypopharynx reconstruction: A case report and literature review

et al. 2021

View full text Add to dashboard Cite

Microsurgical free tissue transfer is nowadays considered to be one of the main options for head and neck reconstruction. The free posterior tibial artery perforator (PTAP) flap is a well‐known reconstructive technique for local defect coverage in the distal leg, and only recently has been employed for head and neck reconstructions. Being a very thin and pliable flap, with low donor site morbidity and constant anatomy, the PTA perforator‐based flap could be a great alternative to the more commonly‐employed radial forearm free flap (RFFF). The present case report shows a complex head and neck defect coverage by means of a free double‐paddle PTA flap, with a concise literature review of previous PTA flap descriptions in this setting. A 59‐year‐old male patient presented with a hypopharynx leakage after radiotherapy due to hypopharynx carcinoma. Since the patient had an occluded ulnar artery on the left side and an arterial line in the radial artery on the right side, both a RFFF and an ulnar artery perforator (UAP) flap were contraindicated. Moreover, two different cutaneous flaps were needed to reconstruct a 6 × 8 cm2 defect, one for the reconstruction of the hypopharynx and one for the resurfacing of the neck, since previous surgeries and radiotherapy led to severe fibrosis of the neck. The patient had a BMI of 25.4 kg/m2, which led us to exclude the anterolateral thigh (ALT) flap because of its thickness. For the forementioned reasons, an unconventional double‐paddle PTAP flap based on two perforator vessels was chosen. Based on two perforators, two skin islands were harvested, building a double‐paddle PTA perforator‐based flap. The proximal skin island was 6 × 7 cm2 and the distal one was 6 × 4 cm2. The larger skin flap was set at the leakage of the hypopharynx. The smaller skin island was used to monitor the survival of the whole flap and for resurfacing the outer side of the neck. The postoperative course was uneventful and at 3 months follow up the reconstructive result was good with no functional drawback. In view of the obtained result, we can consider that the PTA flap might be a reliable alternative to the much widely used RFFF, with a minor donor site morbidity, for delicate head and neck reconstructions.

show abstract

Section: Discussionmentioning

confidence: 99%

Free double‐paddle posterior tibial artery perforator flap for hypopharynx reconstruction: A case report and literature review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…ALT flaps are well known for their versatility and are frequently used in head and neck reconstructive surgery (De Vergilio et al, 2019; Reiter & Baumeister, 2019). This is a first report of successful reconstruction of the thyrohyoid membrane and supraglottis using a free chimeric ALT flap.…”

Section: Discussionmentioning

confidence: 99%

Preservation of laryngeal function through reconstruction of the supraglottis and thyrohyoid membrane with a chimeric anterolateral thigh flap after supraglottic laryngectomy: A case report and literature review

Werner

Scaglioni

et al. 2021

Microsurgery

View full text Add to dashboard Cite

Supraglottic laryngectomy offers a treatment option in laryngeal cancer confined to the supraglottis with the aim to preserve laryngeal functions. Current reconstruction modalities face the challenges of restoring swallow function and preventing chronic aspiration. In this report, we present for the first time a case in which the thyrohyoid membrane and supraglottis were reconstructed using a chimeric anterolateral thigh (ALT) flap. Horizontal supraglottic laryngectomy was performed in a 70‐year‐old male patient with recurrent supraglottic laryngeal cancer after primary radiotherapy. The chimeric ALT flap used for reconstruction measured 7 x 20 cm and was based on two perforators, allowing it to be divided in two parts. The larger deepithelialized fasciocutaneous paddle was used for the reconstruction of the supraglottic defect and the smaller skin paddle was utilized as monitor flap and for neck resurfacing. The chimeric ALT flap was anastomosed to the superior thyroid artery and to a branch of the internal jugular vein. The postoperative recovery was uneventful. Laryngeal functions, including an unimpaired voice, could be preserved. Six months postoperatively, the patient showed no signs of chronic aspiration or tumor recurrence. Using a chimeric ALT free flap for reconstruction after horizontal supraglottic laryngectomy may prevent chronic aspiration through restoration of larynx elevation, mobility, and thus airway protection during deglutition due to increased supraglottic bulk.

show abstract

“…Supraclavicular artery island flap is a kind of fasciocutaneous flap with vascular pedicle, which has been widely employed in reconstruction of the defects of head and neck area, including the mouth base, tongue, 13 oropharynx, 14 hypopharynx, 15 larynx, 4,16 and the neck skin. 17 When repairing defect after laryngectomy, the SAIF is a viable alternative for the classical free flap, such as forearm flap and anterolateral thigh flap.…”

Section: Discussionmentioning

confidence: 99%

Application of the Supraclavicular Artery Island Flap for Fistulas in Patients With Laryngopharyngeal Cancer With Prior Radiotherapy

Chen

Lin

et al. 2020

Ear Nose Throat J

View full text Add to dashboard Cite

Objective: To evaluate the effect of the supraclavicular artery island flap (SAIF) in reconstructing pharyngocutaneous fistula in patients with laryngopharyngeal cancer with prior radiotherapy. Methods: Six patients with laryngopharyngeal cancer with pharyngocutaneous fistula due to previous radiotherapy and surgery during 2016 to 2019 were retrospectively analyzed. Initially, the fistula was treated conservatively. The SAIF was applied with double folding technique to reconstruct fistula in the patients who failed to heal after conservative treatment. Results: The fistulae closed in 4 patients after conservative treatment. After SAIF operation, fistula closure was achieved in the other 2 patients who received highest dose of radiation and had largest fistulae size. The flaps grew well and there were no donor-site complications in these 2 patients. All patients achieved oral feeding without any complications. Conclusion: The SAIF is an effective and safe approach to reconstruct the pharyngocutaneous fistula after laryngopharyngeal surgery in patients with laryngopharyngeal cancer with previous radiotherapy, especially for those who have received high-dose radiation and have large fistula.

show abstract

Reconstruction of laryngopharyngectomy defects: Comparison between the supraclavicular artery island flap, the radial forearm flap, and the anterolateral thigh flap

Cited by 30 publications

References 22 publications

Free double‐paddle posterior tibial artery perforator flap for hypopharynx reconstruction: A case report and literature review

Free double‐paddle posterior tibial artery perforator flap for hypopharynx reconstruction: A case report and literature review

Preservation of laryngeal function through reconstruction of the supraglottis and thyrohyoid membrane with a chimeric anterolateral thigh flap after supraglottic laryngectomy: A case report and literature review

Application of the Supraclavicular Artery Island Flap for Fistulas in Patients With Laryngopharyngeal Cancer With Prior Radiotherapy

Contact Info

Product

Resources

About