Reconstruction of pharyngeal defects

Alcalde, Juan; Gimeno-Vilar, Carlos; Montes‐Jovellar, Lourdes; Manrique, Raquel; Sanhueza, Ignacio

doi:10.1016/s2173-5735(09)70144-9

Cited by 3 publications

(6 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the PMMF also has some disadvantages: excessive soft tissue thickness, an inferior final aesthetic result, and breast asymmetry in females. 4,13,16 The PMMF is too bulky and rigid, leading to possible speech impediment and poor voice rehabilitation; conversely, the IHMCF is thinner and more pliable. Since Wang et al reported using IHMCFs for head and neck reconstructions in 1986, the IHMCF became increasingly known and accepted thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…Use of the IHMCF in head and neck reconstruction is generally successful; it has been used to reconstruct medium-sized defects in the oral cavity (69.8%), oropharynx (21.1%), hypopharynx (4.9%), and larynx (2.2%). 4,15,17 Additionally, the infrahyoid myofascial flap is effective to prevent postoperative pharyngocutaneous fistula formation after total (pharyngo)laryngectomy. 18 Several advantages of this flap are summarized as follows: it is thinner and more pliable than the PMMF; contrary to the free flap, there is no need for microsurgical expertise and instruments (and it is less time consuming); neck dissection can be finished simultaneously by one surgical team, and the donor area can undergo primary closure without additional incision; the anatomical region is familiar to head and neck surgeons, such that harvesting of the IHMCF can be performed quickly and easily; there is no need to change the patient’s position during the surgery; due to the proximity of the donor site to the defect, the flap can be easily transferred without damage of the pedicle; elderly and debilitated patients are considered more suitable for this flap reconstruction; aesthetic and functional outcomes are favorable; and, when complications develop, they are easy to manage.…”

Section: Discussionmentioning

confidence: 99%

“…Accepted reconstructive concepts include free flaps, pedicled flaps, and jejunum flap. 4 Despite the evolution of microvascular free flaps with the advancement of microsurgical techniques, pedicled flaps are widely used to reconstruct defects after head and neck surgery due to their ease of harvesting, viability of the pedicle, and extensive experience of the surgeons using them.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Modified Infrahyoid Myocutaneous Flap for Laryngopharyngeal Reconstruction

2019

View full text Add to dashboard Cite

The laryngopharyngeal reconstruction in patients with pyriform sinus carcinoma continues to be a challenge for surgeons. In this article, we describe our experience with laryngopharyngeal reconstruction in patients with pyriform sinus carcinoma using the modified infrahyoid myocutaneous flap (IHMCF). The modified incision design for the modified IHMCF and clinical outcomes are also detailed here. Between January 2012 and February 2018, 10 patients with hypopharyngeal squamous cell carcinoma who underwent laryngopharyngeal reconstruction using the modified IHMCF after hemicricolaryngopharyngectomy were included in this study. The drainage vessels of the modified IHMCF, oncological outcomes, and functional reservation of the larynx were recorded. All of the flaps survived well. No flap necrosis or other major complications occurred during follow-up. None of the patients remained on nasogastric feeding for more than 4 weeks postoperatively. The follow-up period ranged from 12 to 73 months (mean, 36 months). In our series, 6 patients were successfully decannulated and 5 had received radiation therapy. We roughly assessed the speech and swallowing functions, and the outcomes seemed acceptable in all of the patients after surgery. Laryngoscopic examination showed that the modified IHMCF survived well and the new glottis provided excellent function and good ventilation results. In our experience, the modified IHMCF is a safe and viable procedure that can serve as a valid alternative to free flaps and the pectoralis major myocutaneous flap to reconstruct laryngopharyngeal defects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modified Infrahyoid Myocutaneous Flap for Laryngopharyngeal Reconstruction

2019

View full text Add to dashboard Cite

show abstract

“…Entre los colgajos muscularres y musculocutaneos de rotación más utilizados se encuentran el colgajo de pectoral mayor y el deltopectoral (25,34,(39)(40)(41)(42).…”

Section: Discusionunclassified

Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review

Ruíz

Osorio

Persano

et al. 2017

An. Fac. Cienc. Méd. (Asunción)

View full text Add to dashboard Cite

REPORTE DE CASOUtilización del colgajo muscular en collar del esternocleidomastoideo en el tratamiento quirúrgico del faringostoma. Presentación de un caso y revisión de la literatura Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review RESUMENLa fístula faringocutánea se define como una dehiscencia del cierre de la mucosa faríngea, que produce fuga de saliva y comunicación de la luz faríngea con la piel. Puede clasificarse en fístula propiamente dicha, en el que un trayecto fistuloso comunica luz del tubo digestivo con el exterior y en faringostoma en el que la luz de la faringe se abre directamente al exterior con pérdida importante de tejidos blandos. Es una complicación frecuente tras cirugías abiertas de laringe, pudiendo también aparecer tras cirugías de faringe, de columna espinal, reconstrucciones mandibulares así como en cirugías del piso de boca.Si bien pueden cerrar espontáneamente o con tratamiento conservador, muchas de ellas, sobre todo cuando existe una comunicación amplia entre la faringe y la piel, requieren de cirugía. Existen varias técnicas quirúrgicas para cerrar dichas fístulas. Se presenta un caso en el que se realizó la excéresis de un tumor de base de lengua sangrante, incontrolable, con una faringotomía suprahioidea como vía de abordaje, que presentó como complicación postoperatoria una fístula faringocutánea seguida de la formación de un faringostoma amplio. Fue tratado quirúrgicamente con una síntesis del defecto y refuerzo con colgajo muscular en collar con el fascículo esternal bilateral de esternocleidomastoideo. El paciente presentó buena evolución con cierre de la fístula.Palabras Clave: fistula faringocutánea -faringostoma -cierre -colgajo -esternocleidomastoideo. ABSTRACTPharyngocutaneous fistula is defined as a dehiscence of the closing of the pharyngeal mucosa, which produces leakage of saliva and communication of pharyngeal light with the skin. It can be classified as a fistula proper, in which a fistulous tract communicates light from the digestive tract with the outside and in a pharyngostoma in which the pharyngeal lumen opens directly to the outside with significant loss of soft tissues. It is a frequent complication after open surgeries of the larynx, and may also appear after surgery of the pharynx, spinal column, mandibular reconstructions as well as surgeries of the floor of the mouth. Although they can close spontaneously or with conservative treatment, many of them, especially when there is a wide communication between the pharynx and the skin, require surgery. There are several surgical techniques to close these fistulas. We present a case in which the excresis of a tongue-based tumor was performed, due to uncontrollable bleeding, with a suprahyoid pharyngotomy as the approach, presenting as a postoperative complication a pharyngocutaneous fistula followed by the formation of a broad pharyngostoma. He was treated surgically with a synthesis of the defect and reinforcement with a muscular...

show abstract

“…1,8,17,232 Los avances 131 y las técnicas de reconstrucción de los defectos quirúrgicos, con el uso de injertos músculo-cutáneos microvasculares han conducido a una mejoría en la funcionalidad en los resultados. 1,8,234,235 De forma general, la quimiorradioterapia es el tratamiento estándar cuando la resección quirúrgica no es factible o se esperan malos resultados quirúrgicos funcionales a largo plazo. 1,8,232 El metaanálisis MACH-NC que incluyó a 19.248 pacientes con carcinoma de células escamosas localmente avanzado resecable o no resecable de cabeza y cuello, demostró que la quimiorradioterapia (QTRT) combinada con cirugía reducía la mortalidad a los 5 años en 6,5 puntos porcentuales (HR 0,83; IC95%, 0,79-0,87; p=0,001) y disminuía las tasas de recaída locorregional.…”

Section: Estadio III Avanzado (T1-t3n1) Iva (T1-t3 N2a-b) Iva (T1-3 N...unclassified

Braquiterapia adyuvante de alta tasa de dosis en el tratamiento de pacientes con carcinoma de cabeza y cuello: aplicabilidad de los datos dosimétricos

García-Consuegra

View full text Add to dashboard Cite

ADC Coeficiente de Diffusion Aparente AJCC American Joint Committee on Cancer AMV Análisis Multivariante AUV Análisis Univariante AUC Area Under the Curve b.i.d bis in die BRCA Breast Cancer Gene 1 CCND1 Cyclin D1 CTCAE Common Terminology Criteria for Adverse Events CTV Clinical Target Volume DVH Dose Volume Histogram ADN Ácido Desoxirribonucleico EBRT/RTE External Beam Radiation Therapy/Radioterapia externa EGFR Epidermal Growth Factor Receptor ERBB Erythroblastic leukemia viral oncogene homologue EQD2-DVH (EUD) Equivalent Uniform Dose GEC-ESTRO Groupe Européen de Curiethérapie (GEC) and European Society for Radiotherapy & Oncology (ESTRO) ECS Extracapsular spread EQD2 Equivalent Dose 2Gy FDG Fluorodeoxyglucosa Gy Gray GTV Gross Tumor Volume DHI Homogeneity Index HER2 Receptor Tirosina-proteína Quinasa erbB-2 HTA Hipertensión Arterial HDRB High Dose Rate Brachytherapy HR Hazard Ratio

show abstract

Reconstruction of pharyngeal defects

Cited by 3 publications

References 25 publications

Modified Infrahyoid Myocutaneous Flap for Laryngopharyngeal Reconstruction

Modified Infrahyoid Myocutaneous Flap for Laryngopharyngeal Reconstruction

Use of the sternocleidomastoid muscle collar flap in the surgical treatment of the pharyngostoma. Case report and literature review

Braquiterapia adyuvante de alta tasa de dosis en el tratamiento de pacientes con carcinoma de cabeza y cuello: aplicabilidad de los datos dosimétricos

Contact Info

Product

Resources

About