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
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