JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2018, Vol. 32 ›› Issue (1): 48-52.doi: 10.6040/j.issn.1673-3770.0.2017.525

Previous Articles     Next Articles

The application of pedicle tissue flaps in reconstruction of pharyngeal and esophageal defects in head and neck surgery

LI Xuexin, JIANG Zhen, YUE Jianlin, LIN Yun, SUN Ruijie, LIU Dayu, PAN Xinliang   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2017-12-15 Online:2018-01-20 Published:2018-01-20

Abstract: Objective To evaluate the application and outcomes of pedicle tissue flaps in reconstruction of pharyngeal and esophageal defects in head and neck surgery. Methods This was a retrospective analysis of 186 operative cases in patients with malignant diseases in the Department of Otolaryngology, Qilu Hospital of Shandong University. The patients underwent reconstruction of defects using pectoralis myocutaneous flaps, sternohyoid flaps, tongue flaps, laryngotracheal flaps, pharyngogastric anastomoses, and pharyngocolonic anastomoses. Results Four patients had laryngeal cancer, 87 had hypopharyngeal cancer, 5 had thyroid cancer, 2 had tonsil cancer, 38 had cervical esophageal cancer, and 15 had pharyngocutaneous fistulas. Reconstruction was performed with single or combined pectoralis major myocutaneous flaps in 71 cases; 2 underwent reconstruction with a tongue flap combined with laryngotracheal and pectoralis major myocutaneous flaps, with recovery of swallowing function; 38 of 40 underwent reconstruction with laryngotracheal flaps, with recovery of swallowing function; 55 of 58 underwent reconstruction with single or combined pharyngogastric anastomoses, with recovery of swallowing function, and with preservation of laryngeal function in 53.4%; and 13 of 15 underwent reconstruction with single or combined pharyngocolonic anastomoses, with recovery of swallowing function, and with preservation of laryngeal function in 93.3%. Conclusion Pedicle tissue flaps meet the requirements for reconstruction of pharyngeal and esophageal defects in head and neck surgery. These flaps have a good blood supply, mature technology, and are easy to perform, requiring less operative skill. Moreover, these flaps play an important role in one-stage reconstruction in head and neck surgery when used flexibly.

Key words: Head and neck tumor, Reconstruction, Surgical flap

CLC Number: 

  • R766
[1] 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.
[2] 李晓明,宋琦,李红霞,等. 胸大肌肌皮瓣在侵犯下咽晚期头颈鳞癌手术切除术后缺损修复中的应用[J]. 山东大学耳鼻喉眼学报,2016,30(3):4-9. LI Xiaoming, SONG Qi, LI Hongxia, et al. Reconstruction of hypopharyngeal defects after ablation of advanced head and neck squamous carcinoma invol-ving hypophaynx with pectoralis major myocutaneous flap[J]. J Otolaryngol Ophthal Shandong Univ, 2016, 30(3):4-9.
[3] Kruse AL, Luebbers HT, Obwegeser JA, et al. Evaluation of the pectoralis major flap for reconstructive head and neck surgery[J]. Head Neck Oncol, 2011, 3:12. DOI:10.1186/1758-3284-3-12.
[4] Po-Wing, Yuen A. Preservation of lateral thoracic artery to improve vascular supply of distal skin without compromising pedicle length in harvesting pectoralis major myocutaneous flap[J]. J Plast Reconstr Aesthet Surg, 2006, 59(12):1433-1435.
[5] Louis G, Portugal, Ankit M, et al. Pharyngeal reconstruction[J]. Oper Tech Otolaryngol Head Neck Surg, 2000, 11(3):166-168.
[6] 潘新良,栾信庸,解光,等. 胸大肌肌皮瓣在耳鼻咽喉头颈外科中的应用[J]. 山东大学耳鼻喉眼学报,2005,19(5):277-282. PAN Xinliang, LUAN Xinyong, XIE Guang, et al. Application of pectoralis major myocutaneous flap in otorhinolaryngology & head and neck surgery[J]. J Otolaryngol Ophthal Shandong Univ, 2005, 19(5):277-282.
[7] Cordova A, Corradino B, Pirrello R, et al. Surgical treatment of pharyngostomes in irradiated patients. Our experience with musculocutaneous pectoralismajor flap and hyperbaric oxygen therapy[J]. Acta Otolaryngol, 2005, 125(7):759-764.
[8] Deshmukh A, Kannan S, Thakkar P, et al. Tongue flap revisited[J]. J Cancer Res Ther, 2013, 9(2):215-218.
[9] Calcaterra TC. Reconstruction of laryngopharynx cavity by tongue flap[J]. J Otolaryngol Clin North Am, 1988, 21(1):53-63.
[10] 张庆泉,邢建萍,宋西成,等.舌瓣修复咽喉术后缺损的临床应用[J].中华耳鼻咽喉科杂志,2000,35(5):138-140.
[11] Strauss RA, Kain NJ. Tongue flaps[J]. Oral Maxillofac Surg Clin North Am, 2014, 26(3):313-325.
[12] Deshmukh A, Kannan S, Thakkar P, et al. Tongue flap revisited[J]. J Cancer Res Ther, 2013, 9(2):215-218.
[13] 林庆海,王挥戈,林心强. 残喉气管瓣修复晚期下咽及颈段食管癌术后咽食管缺损10例分析[J]. 中国耳鼻咽喉颅底外科杂志,2015,21(3):229-233. LIN Qinghai, WANG Huige, LIN Xinqiang. Repair of defect after hypopharyngo-cervical esophagectomy with laryngo-tracheal flap[J]. Chin J Otorhinolaryngo Skull Base Surg, 2015, 21(3):229-233.
[14] Nouraei SA, Dias A, Kanona H, et al. Impact of the method and success of pharyngeal reconstruction on the outcome of treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy: a national analysis[J]. J Plast Reconstr Aesthet Surg, 2017, 70(5):628-638.
[15] Ragbir M, Brown JS, Mehanna H. Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines[J]. J Laryngol, 2016, 130(2):191-197.
[16] Nakabayashi T, Mochiki E, Kamiyama Y, et al. Gastric motor activity in gastric pull-up esophagectomized patients with and without reflux symptoms[J]. Ann Thorac Surg, 2012, 94(4):1114-1117.
[17] Selber JC, Xue A, Liu J, et al. Pharyngoesophageal reconstruction outcomes following 349 cases[J]. J Reconstr Microsurg, 2014, 30(9):641-654.
[18] 潘新良,栾信庸,关方霞,等. 结肠上徙治疗良性咽、食管狭窄[J].山东医科大学学报,1999,13(2):821-823. PAN Xinliang, LUAN Xinyong, GUAN Fangxia, et al. Colon interposition for benign pharyngo-esophageal stenosis[J]. J Preclinical Med College Shandong Med Univ, 1999, 13(2):821-823.
[19] Radovanovic N, Simic A, Kotarac M, et al. Colon interposition for pharyngoesophageal postcorrosive strictures[J]. Hepatogastroenterology,2009,56(89):139-143.
[1] GAO Qige, ZHANG Hua. Treatment of pulsatile tinnitus: a literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(2): 95-101.
[2] QU Xiangyu, ZHU Han, LIU Zhonglu, MU Yakui, GUO Wentao, ZHANG Hua. Application of epiglottic tongue flap in supraglottic defect repair of laryngeal cancer [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 77-84.
[3] ZHANG Jingyi, DONG Xiangyi, MU Yakui, SONG Xicheng. Research progress on pyroptosis in otorhinolaryngology diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 140-148.
[4] GUO Sirui, MO Ya. Computer-aided 3D reconstruction based on CT imaging for guidance in lacrimal duct surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 175-182.
[5] LIU Yuhong, BO Lin, LIU Xingang, SU Faren, MA Qifa. Pedicled superficial temporal fascia flap and local skin graft combined with cartilage transplantation effectively repair cartilage scaffold exposure in auricular reconstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 9-12.
[6] LI Baofei, AINIWAER·Mailudan, YANG Xin, CHEN Fei. The application of adipofascial anterolateral thigh flap in reconstruction of the head and neck [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 87-91.
[7] LI Xiaoyu, ZHAO Danheng, LIU Ya, LIU Yang. Preliminary analysis of the position and related factors of titanium ossicular prostheses during mastoid and tympanic revision surgeries [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 1-5.
[8] ZHU Jun, NIE RuyaOverview,LI GuoyiGuidance. The advances in application of mastoid obliteration materials in mastoidectomy canal wall down with tympanoplasty [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 111-116.
[9] ZHANG Lijun, XU Ran, LUO Jifang, LIU Guoqi, HE Qian, LI Wei, JIANG Zhenhua. Factors affecting flap neurosis and other postoperative flap-related complications after free-flap reconstruction of head and neck tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 86-90.
[10] WU Zebin,QIU Qianhui. Endoscopic surgery for skull base lesions in pediatric patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 112-117.
[11] ZHU Huaming, GUAN Jian, MAO Song, ZHANG Weitian, YI Hongliang. Clinical analysis of low-temperature plasma radiofrequency ablation for benign tumors in the parapharyngeal space [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 28-33.
[12] . The swallowing function recovery study on tongue flap after horizontal hemilaryngectomy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 127-131.
[13] DENG Di, LIU Jun, LI Linke, WANG Ji, LIU Jifeng, LV Dan, WANG Haiyang, GAN Weigang, WANG Jun, LI Bo, CHEN Fei. Two-stage reconstructive strategy using a flap for non-circumferential tracheal defects [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 52-57.
[14] SU Faren, LIU Yuhong, BO Lin, LIU Xingang. A negative pressure drainage device for dermal dilatation of microtia in the second phase of auricular reconstruction surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 125-128.
[15] Zhili WANG,Zhe CHEN,Fangyu LIN,Yongchuan CHAI,Zhaoyan WANG. Facial nerve reconstruction in the parotid area under a variety of circumstances [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 15-19.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!