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Reconstruction of the larynx and aryepiglottic fold using a free radial forearm tendocutaneous flap after partial laryngopharyngectomy: A case report
Author(s) -
Mihara Makoto,
Iida Takuya,
Hara Hisako,
Hayashi Yohei,
Yamamoto Takumi,
Mitsunaga Narushima,
Todokoro Takeshi,
Uchida Gentaro,
Koshima Isao
Publication year - 2012
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20940
Subject(s) - medicine , swallowing , larynx , surgery , phonation , microsurgery , free flap , anatomy , audiology
The patient was a 62‐year‐old man with chief complaints of pharyngeal pain and dysphagia. He was diagnosed with pyriform sinus poorly differentiated squamous cell carcinoma T3N0M0 (Stage II) and underwent partial laryngopharyngectomy, lymphadenectomy in the right neck, tracheostomy, and reconstruction of the larynx and aryepiglottic fold with a free radial forearm flap and the associated vascularized palmaris longus tendon. No particular problems occurred after surgery, and swallowing and articulation functions were successfully recovered. A free jejunum transfer is the first choice for reconstruction of a defect after partial hypopharyngectomy, but reconstruction of the supracricoid complex structure of the larynx using a free jejunum transfer after partial laryngopharyngectomy may lead to aspiration of intestinal fluids. In this case, we performed functional reconstruction of the laryngopharyngeal defect using a free radial forearm flap including a vascularized tendon of the palmaris longus, and satisfactory postoperative function was achieved. We believe that the key to successful functional recovery after partial laryngopharyngectomy is establishment of the three‐dimensional complex structure of the arytenoid and aryepiglottic fold. © 2011 Wiley Periodicals, Inc. Microsurgery, 2012.