Volume 13, Issue 2 (2024)                   WJPS 2024, 13(2): 77-81 | Back to browse issues page


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Ignacio L B, Marisol G G, Cristina O M, Armando U B D, Fernando D M A. Pharyngoesophageal Reconstruction with A Tubed Radial Forearm Free Flap: A Case Report. WJPS 2024; 13 (2) :77-81
URL: http://wjps.ir/article-1-1293-en.html
1- Plastic and Reconstructive Surgery Department at Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico
2- Plastic and Reconstructive Surgery Department at Centro Medico Nacional 20 de Noviembre, Mexico City, Mexico , allanferdelcid@gmail.com
Abstract:   (1028 Views)
Hypopharyngeal carcinoma is one of the most aggressive primary head and neck cancers, often managed through partial or total laryngopharyngectomy. Reconstruction after such surgeries remains a challenging procedure that often requires the use of free flaps. A 63-year-old male patient with in-situ squamous cell carcinoma of the left vocal cord treated with total pharyngolaryngectomy and primary reconstruction with a left radial forearm free flap, complicated by flap necrosis, which ended up in dismantling and gastrostomy. He was referred to the Plastic and Reconstructive Surgery Department at Centro Medico Nacional 20 de Noviembre, Mexico in 2023 to assess the reconstructive options for the hypopharynx and cervical esophagus defect. A tubular right radial forearm free flap was designed forming the anterior wall of the hypopharynx and cervical esophagus and a posterior wall for the external defect. Twelve months after his surgery, he continues tolerating oral intake without signs of stenosis or tumor recurrence. The objective in this case was based on restoring the continuity of the digestive tract and swallowing function, as well as providing skin coverage of the defects, and preventing serious complications. The radial forearm free flap has versatility in the tubular construction and a low leak rate, as well as an adequate skin island size. Conclusion: The pharyngoesophageal reconstruction with a tubed forearm free flap has favorable outcomes for restoring the gastrointestinal tract without further complications.
 
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Type of Study: case report | Subject: Special
ePublished: 2024/07/31

References
1. Heng Y, Zhang D, Zhu X, et al. Hypopharynx reconstruction for primary hypopharyngeal carcinoma: a retrospective study and literature review. Transl Cancer Res 2021;10(7):3236-3247. doi:10.21037/tcr-20-2910 [DOI:10.21037/tcr-20-2910]
2. Piazza C, Bon FD, Paderno A, Grammatica A, Montalto N, Taglietti V, et al. Fasciocutaneous free flaps for reconstruction of hypopharyngeal defects. The Laryngoscope 2017;127(12):2731-7. doi:10.1002/lary.26705 [DOI:10.1002/lary.26705]
3. Sharaf B, Xue A, Solari MG, et al. Optimizing Outcomes in Pharyngoesophageal Reconstruction and Neck Resurfacing: 10-Year Experience of 294 Cases. Plast Reconstr Surg 2017;139(1):105e-119e. doi:10.1097/PRS.0000000000002915 [DOI:10.1097/PRS.0000000000002915]
4. Disa JJ, Pusic AL, Hidalgo DA, Cordeiro PG. Microvascular reconstruction of the hypopharynx: defect classification, treatment algorithm, and functional outcome based on 165 consecutive cases. Plast Reconstr Surg 2003;111(2):652-663. doi:10.1097/01.PRS.0000041987.53831.23 [DOI:10.1097/01.PRS.0000041987.53831.23]
5. Harii K, Ebihara S, Ono I, Saito H, Terui S, Takato T. Pharyngoesophageal reconstruction using a fabricated forearm free flap. Plast Reconstr Surg 1985;75(4):463-476. doi:10.1097/00006534-198504000-00001 [DOI:10.1097/00006534-198504000-00001]
6. Somuk BT, Çiftçi O, Aygenç E. Evaluation of Cases Who Underwent Reconstruction Through Pectoralis Major Myocutaneous Flap after Laryngopharyngectomy. Turk Arch Otorhinolaryngol 2016;54(2):58-62. doi:10.5152/tao.2016.1603 [DOI:10.5152/tao.2016.1603]
7. Richmon JD, Brumund KT. Reconstruction of the hypopharynx: current trends. Curr Opin Otolaryngol Head Neck Surg 2007;15(4):208-212. doi:10.1097/MOO.0b013e32825b0852 [DOI:10.1097/MOO.0b013e32825b0852]
8. Selber JC, Xue A, Liu J, et al. Pharyngoesophageal reconstruction outcomes following 349 cases. J Reconstr Microsurg 2014;30(9):641-654. doi:10.1055/s-0034-1376887 [DOI:10.1055/s-0034-1376887]
9. Scharpf J, Esclamado RM. Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer. Head Neck 2003;25(4):261-266. doi:10.1002/hed.10197 [DOI:10.1002/hed.10197]
10. Lasso JM, Castellano M, Pinilla C, González-Pozega C, Pérez-Cano R. Circumferential pharyngoesophageal reconstruction and total larynx preservation with extra-anatomical free flaps. Plast Reconstr Surg Glob Open 2018;6(11):e2008. doi:10.1097/gox.0000000000002008 [DOI:10.1097/GOX.0000000000002008]
11. Marzouki H, Addas MA, Nujoom M, Zawawi F, Almarzouki HZ, Merdad M. Hypopharyngeal reconstruction: Possibilities, outcomes, and updates for improving the human health for quality of life. Comput Intell Neurosci 2022;2022:1-10. doi:10.1155/2022/6132481 [DOI:10.1155/2022/6132481]
12. Welkoborsky H-J, Deichmüller C, Bauer L, Hinni ML. Reconstruction of large pharyngeal defects with microvascular free flaps and myocutaneous pedicled flaps. Curr Opin Otolaryngol Head Neck Surg 2013;21(4):318-327. doi:10.1097/moo.0b013e3283631ea2 [DOI:10.1097/MOO.0b013e3283631ea2]
13. Van der Putten L, Spasiano R, de Bree R, et al. Flap reconstruction of the hypopharynx: a defect oriented approach. Acta Otorhinolaryngol Ital 2012;32(5):288-296. PMID: 23326007; PMCID: PMC3546404.
14. Hong JW, Jeong HS, Lew DH, Roh TS, Tark KC, Choi EC, et al. Hypopharyngeal reconstruction using remnant narrow pharyngeal wall as omega-shaped radial forearm free flap. J Craniofac Surg 2009;20(5):1334-1340. doi:10.1097/scs.0b013e3181ae66a9 [DOI:10.1097/SCS.0b013e3181ae66a9]

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