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Use of the radial forearm fasciocutaneous free flap and Montgomery salivary bypass tube for pharyngoesophageal reconstruction
Author(s) -
Varvares Mark A.,
Cheney Mack L.,
Gliklich Richard E.,
Boyd James M.,
Goldsmith Tessa,
Lazor John,
Baron John C. M.,
Montgomery William W.
Publication year - 2000
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/1097-0347(200008)22:5<463::aid-hed4>3.0.co;2-s
Subject(s) - medicine , surgery , laryngectomy , larynx , forearm , head and neck , esophagus
Background Head and neck reconstructive surgeons involved in pharyngoesophageal reconstruction have several options available to repair the defect after partial or total laryngopharyngectomy. There is no uniform agreement among head and neck surgeons as to which of the most frequently used techniques offers the best results. Methods A retrospective study was performed on 20 consecutive patients who had undergone reconstruction of the hypopharynx and cervical esophagus using a radial forearm free flap with Montgomery salivary bypass tube at the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts, and St. Louis University, Department of Otolaryngology–Head and Neck Surgery between 1992 and 1996. This reconstruction was used for primary reconstruction after total or partial laryngopharyngectomy with cervical esophagectomy, partial pharyngectomy sparing the larynx, and for reconstruction of the stenotic neopharynx after laryngectomy. Results The overall rate of pharyngocutaneous fistula was 20%, and the rate of postoperative stricture was 10%. Of patients reconstructed with this technique, 85% were able to resume oral alimentation, whereas 15% remained G‐tube dependent. Of the 18 patients who did not have their larynges remain intact, 6 were able to develop useful tracheoesophageal speech. Conclusions The results of this study show that the radial forearm fasciocutaneous free flap in combination with the Montgomery salivary bypass tube is extremely useful for reconstruction of partial and circumferential defects of the hypopharynx and cervical esophagus. © 2000 John Wiley & Sons, Inc. Head Neck 22: 463‐468, 2000.