Management of an acquired tracheoesophageal fistula with a fascial free flap

Background Failure in the primary repair of a benign acquired tracheoesophageal fistula limits the operative options available at revision. Use of a fascial free flap to treat this condition has not been previously reported. Methods We review the case of a patient who had a tracheoesophageal fistula develop after percutaneous tracheostomy, who had failed previous primary repair with strap muscle interposition. Results A radial forearm fascial free flap was used at revision and resulted in resolution of the fistula. Conclusion Use of a fascial free flap to address a persistent acquired tracheoesophageal fistula, when an accompanying stenotic segment is not present, is a viable treatment option. © 2002 Wiley Periodicals, Inc. Head Neck 24: 609–613, 2002