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Morbidity and functional outcomes following gastro‐omental free flap reconstruction of circumferential pharyngeal defects
Author(s) -
Patel Rajan S.,
Makitie Antti A.,
Goldstein David P.,
Gullane Patrick J.,
Brown Dale,
Irish Jonathan,
Gilbert Ralph W.
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.21016
Subject(s) - medicine , surgery , radiation therapy , tracheoesophageal fistula , fistula , osteoradionecrosis
Background. In patients with extensive soft tissue fibrosis requiring circumferential pharyngeal reconstruction following definitive radiotherapy and/or chemotherapy, we take advantage of abundant omental progenitor factors in the tubed gastro‐omental free flap. This study reviews our experience with this flap. Methods. Review of 11 patients (median follow‐up, 2.8 years) undergoing total pharyngolaryngectomy following organ preservation protocols for recurrent squamous cell carcinoma ( n = 9) and stricture ( n = 2). Results. Operative morbidity and mortality rates were 54% and 9%, respectively. One patient died following carotid rupture. Complications included: chyle leak (18%), pharyngocutaneous fistula (9%), and late stricture (27%). Ten patients (91%) achieved oral diet, and all 7 patients (100%) considered suitable for tracheoesophageal speech rehabilitation achieved functional speech. Seven patients remain alive without disease at a median of 41 months following surgery. Conclusions. The gastro‐omental flap provides a viable option in high‐risk patients undergoing circumferential pharyngeal reconstruction. © 2009 Wiley Periodicals, Inc. Head Neck, 2009