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Efficacy of pectoralis major muscle flap for pharyngocutaneous fistula prevention in salvage total laryngectomy: A systematic review
Author(s) -
Guimarães André Vicente,
Aires Felipe Toyama,
Dedivitis Rogério Aparecido,
Kulcsar Marco Aurélio Vamondes,
Ramos Daniel Marin,
Cernea Claudio Roberto,
Brandão Lenine Garcia
Publication year - 2016
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.24248
Subject(s) - laryngectomy , medicine , surgery , fistula , incidence (geometry) , pectoralis major muscle , larynx , physics , optics
Background The role of pectoralis major muscle flap (PMMF) in reducing the rate of pharyngocutaneous fistula after salvage total laryngectomy has not been clearly established. The purpose of this study was to evaluate the impact of PMMF in reducing pharyngocutaneous fistula rates after total laryngectomy. Methods The analyzed intervention was the use of a PMMF after total laryngectomy. Results Pharyngocutaneous fistula occurred in 230 cases (global incidence, 30.9%). In the group of patients who underwent PMMFs, there were 49 cases of pharyngocutaneous fistula, compared with 181 cases in the control group. There was a 22% decreased risk of pharyngocutaneous fistula incidence in the PMMF group ( p < .001). Patients who underwent a PMMF had lower risk of pharyngocutaneous fistula compared with the control group ( p = .008). There were no changes when only patients who underwent total laryngectomy ( p < .001) and those who underwent total pharyngolaryngectomy ( p = .007) were separately assessed. Conclusion Prophylactic use of PMMF decreases the incidence of pharyngocutaneous fistula after salvage total laryngectomy. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E2317–E2321, 2016