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Prevention of pharyngocutaneous fistula in salvage total laryngectomy: role of the pectoralis major flap and peri-operative management.

Abstract This study aimed to evaluate the impact of an onlay pectoralis major flap in reducing the incidence of pharyngocutaneous fistula after salvage total laryngectomy and determine the complications of pectoralis major flap reconstruction.
PMID
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Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy.

Authors

Mayor MeshTerms

Surgical Flaps

Keywords

Fistula

Hypopharynx

Laryngectomy

Larynx

Myocutaneous Flap

Pectoralis Muscle

Journal Title the journal of laryngology and otology
Publication Year Start




PMID- 29512475
OWN - NLM
STAT- MEDLINE
DCOM- 20180313
LR  - 20180313
IS  - 1748-5460 (Electronic)
IS  - 0022-2151 (Linking)
VI  - 132
IP  - 3
DP  - 2018 Mar
TI  - Prevention of pharyngocutaneous fistula in salvage total laryngectomy: role of
      the pectoralis major flap and peri-operative management.
PG  - 246-251
LID - 10.1017/S0022215118000178 [doi]
AB  - OBJECTIVE: This study aimed to evaluate the impact of an onlay pectoralis major
      flap in reducing the incidence of pharyngocutaneous fistula after salvage total
      laryngectomy and determine the complications of pectoralis major flap
      reconstruction. METHODS: A retrospective study was conducted of consecutive
      patients who underwent salvage total laryngectomy between 1995 and 2016. The
      pharyngeal defects were primarily closed with or without the pectoralis major
      flap. RESULTS: Of 64 patients, 34 had primary pharyngeal closure alone (control
      group) and 30 received an onlay pectoralis major flap (pectoralis major flap
      group). The overall fistula rate was 15.6 per cent, with 17.6 per cent occurring 
      in the control group and 13.3 per cent in the pectoralis major flap group (p =
      0.74). The incidence rates of voice failure (p = 0.02) and shoulder disability (p
      < 0.001) were significantly higher in the pectoralis major flap group.
      CONCLUSION: The pectoralis major flap in salvage total laryngectomy did not
      decrease the pharyngocutaneous fistula rate, and the incidence of flap-related
      complications was high. Appropriate surgical technique and post-operative care
      may reduce the incidence of pharyngocutaneous fistula.
FAU - Sittitrai, P
AU  - Sittitrai P
AD  - Department of Otolaryngology,Chiang Mai University Hospital,Thailand.
FAU - Srivanitchapoom, C
AU  - Srivanitchapoom C
AD  - Otolaryngology Unit,Phayao Hospital,Thailand.
FAU - Reunmakkaew, D
AU  - Reunmakkaew D
AD  - Department of Otolaryngology,Chiang Mai University Hospital,Thailand.
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Laryngol Otol
JT  - The Journal of laryngology and otology
JID - 8706896
RN  - Carcinoma, squamous cell of head and neck
SB  - AIM
SB  - IM
MH  - Aged
MH  - Carcinoma, Squamous Cell/*surgery
MH  - Cutaneous Fistula/*prevention & control
MH  - Female
MH  - Head and Neck Neoplasms/*surgery
MH  - Humans
MH  - Hypopharyngeal Neoplasms/*surgery
MH  - Incidence
MH  - Laryngeal Neoplasms/*surgery
MH  - Laryngectomy/*methods
MH  - Male
MH  - Middle Aged
MH  - Pectoralis Muscles/*transplantation
MH  - Pharyngeal Diseases/*prevention & control
MH  - Postoperative Complications/epidemiology/*prevention & control
MH  - Reconstructive Surgical Procedures/methods
MH  - Retrospective Studies
MH  - Salvage Therapy/methods
MH  - Shoulder
MH  - *Surgical Flaps
MH  - Voice Disorders/epidemiology
OTO - NOTNLM
OT  - Fistula
OT  - Hypopharynx
OT  - Laryngectomy
OT  - Larynx
OT  - Myocutaneous Flap
OT  - Pectoralis Muscle
EDAT- 2018/03/08 06:00
MHDA- 2018/03/14 06:00
CRDT- 2018/03/08 06:00
PHST- 2018/03/08 06:00 [entrez]
PHST- 2018/03/08 06:00 [pubmed]
PHST- 2018/03/14 06:00 [medline]
AID - S0022215118000178 [pii]
AID - 10.1017/S0022215118000178 [doi]
PST - ppublish
SO  - J Laryngol Otol. 2018 Mar;132(3):246-251. doi: 10.1017/S0022215118000178.