Premium
Closure of tracheoesophageal fistula with prefabricated revascularized bilaminar radial forearm free flap
Author(s) -
Wreesmann Volkert B.,
Smeele Ludi E.,
Hilgers Frans J. M.,
Lohuis Peter J. F. M.
Publication year - 2009
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/hed.20971
Subject(s) - medicine , surgery , tracheoesophageal fistula , forearm , free flap , fistula , complication
Background Tracheoesophageal fistula (TEF) is a rare but serious complication associated with high mortality rates. Traditional management of TEF includes primary closure with or without interposition of regional tissue flaps but is associated with a significant recurrence risk, especially in case of larger fistulas. Application of microvascular free flap reconstruction is an emerging alternative in the surgical management of large TEFs, but may be limited by issues of flap bulkiness and requirement for neoepithelialization across the large inner flap surface. Methods and Results Here, we report prefabrication of a bilaminar radial forearm free flap to successfully close a large recurrent TEF that occurred years after tracheoesophageal puncture‐based voice rehabilitation in a laryngectomized patient. Conclusion The bilaminar radial forearm free flap may prove to be an important adjunct to the closure of large TEFs. © 2008 Wiley Periodicals, Inc. Head Neck, 2009