JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2016, Vol. 30 ›› Issue (3): 4-9.doi: 10.6040/j.issn.1673-3770.0.2016.233

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Reconstruction of hypopharyngeal defects after ablation of advanced head and neck squamous carcinoma involving hypophaynx with pectoralis major myocutaneous flap.

LI Xiaoming, SONG Qi, LI Hongxia, TAO Zhenfeng, SHEN Yupeng, XIAO Shufen   

  1. Deparment of Otolaryngology Head Neck Surgery, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Hebei, China
  • Received:2016-05-20 Online:2016-06-16 Published:2016-06-16

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Abstract: Objective To explore the eligibility of using pectoralis major myocutaneous flap(PMF)to reconstruct major and complex defects in the hypopharngeal and cervical esophageal regions. Methods PMF with or without combinations of other reconstructive tissue flaps were used with some modifications to surgical techniques. Major or complex defects were caused in 59 patients after en bloc removal of advanced and recurrent hypopharyngeal and laryngeal cancers, which included partial and circumferential hypopharyngeal defects, and circumferential pharyngeal defects with complex soft tissue defects in the anterior neck. Results Single patch-on PMF was used in 26 cases, patch-on PMF with anterior vertebral skin graft in 4 cases, patch-on PMF with anterior neck skin graft in 2 cases, patch-on PMF with deltopectoral flap in 2 cases, tubed PMF in 16 cases, tubed PMF with deltopectoral flap in 4 cases, gastric pull-up plus PMF in 4 cases, and double-paddled PMF in 2 cases. Post-operative complications were encountered in 20 cases, which were managed properly. All patients were healed and restored their swallowing function, except one patient who died in hospital. Conclusion PMF is suitable for reconstruction of nearly all kinds of defects in hypopharyngeal and cervical esophageal regions, especially for those with complex soft tissue defects in the anterior neck.

Key words: Pectoralis major myocutaneous flap, Hypopharyngeal defects, Hypopharyngeal cancer, Surgical reconstruction, Laryngeal cancer

CLC Number: 

  • R766.9
[1] Wei W I, Lam L K, Chan V S. Current reconstruction options following tumour extirpation in head and neck surgery[J]. Asian J Surg, 2002, 25(1):41-48.
[2] 陈晓红. 头颈肿瘤术后缺损修复重建的回顾和展望[J]. 中国耳鼻咽喉头颈外科, 2016, 23(3):125-126.
[3] Onoda S, Azumi S, Miura Y, et al. Head and neck reconstruction by using extended pectoralis major myocutaneous flap[J]. J Reconstr Microsurg, 2015, 31(4):300-304.
[4] Sadigh P L, Chang L R, Hsieh C H, et al. The trapezius perforator flap: an underused but versatile option in the reconstruction of local and distant soft-tissue defects[J]. Plast Reconstr Surg, 2014, 134(3):449e-456e.
[5] Jeong W S, Roh J L, Kim E K. Extensive scalp reconstruction after repeated failure of free tissue transfer with a pedicled latissimus dorsi flap[J]. J Craniofac Surg, 2014, 25(3):1103-1105.
[6] Cheng A, Bui T. Submental island flap[J]. Oral Maxillofac Surg Clin North Am, 2014, 26(3):371-379.
[7] Ferrari S, Copelli C, Bianchi B, et al. The submental island flap: pedicle elongation and indications in head and neck reconstruction[J]. J Craniomaxillofac Surg, 2014, 42(6):1005-1009.
[8] Li Z, Cui J, Zhang Y X, et al. Versatility of the thoracoacromial artery perforator flap in head and neck reconstruction[J]. J Reconstr Microsurg, 2014, 30(7):497-503.
[9] Jeremic J V, Nikolic Z S. Versatility of radial forearm free flap for intraoral reconstruction[J]. Srp Arh Celok Lek, 2015, 143(5-6):256-260.
[10] Chuang H C, Su C Y, Jeng S F, et al. Anterior lateral thigh flap for buccal mucosal defect after resection of buccal cancer[J]. Otolaryngol Head Neck Surg, 2007, 137(4):632-635.
[11] Amin A, Rifaat M, Civantos F, et al. Free anterolateral thigh flap for reconstruction of major craniofacial defects[J]. J Reconstr Microsurg, 2006, 22(2):97-104.
[12] Wehage I C, Fansa H. Complex reconstructions in head and neck cancer surgery: decision making[J]. Head Neck Oncol, 2011, 3(1):14.
[13] Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck[J]. Plast Reconstr Surg, 1979, 63(1):73-81.
[14] 陈杰, 黄文孝, 李赞, 等. 改良胸大肌肌皮瓣修复头颈肿瘤术后组织缺损[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(5):388-391. CHEN Jie, HUANG Wenxiao, LI Zan, et al. Modified pectoralis major myocutaneous flap in reconstruction of head and neck defects[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2015, 50(5):388-391.
[15] 徐伟, 吕正华, 张俊, 等. 胸大肌肌皮瓣卷筒在下咽颈段食管环周缺损修复中的应用[J]. 中华耳鼻咽喉头颈外科杂志, 2010, 45(5):401-405. XU Wei, LÜ Zhenghua, ZHANG Jun, et al. Tubed pectoralis major myocutaneous flap for reconstruction of circumference pharyngoesophageal defects[J]. Chin J Otorhinolaryngol Head Neck Surgery, 2010, 45(5):401-405.
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