A new option with the pedicle thoracoacromial artery perforator flap for hypopharyngeal reconstructions

Laryngoscope. 2016 Jun;126(6):1315-20. doi: 10.1002/lary.25675. Epub 2015 Sep 22.

Abstract

Objectives/hypothesis: The reconstruction of hypopharyngeal defects should focus on minimizing morbidity in a high-risk population while achieving adequate functional results with regard to the restoration of speech, swallowing, and airway control. We introduce the clinical application of the thoracoacromial artery perforator (TAAP) flap as a new reconstructive option for hypopharyngeal defects.

Methods: This method was used to restore oncologic hypopharyngeal defects in nine patients: three who had previous irradiation and surgery, one who had previous surgery only, and another who had previous radiotherapy only.

Results: All of the TAAP flaps of our series were transferred successfully and survived entirely. The donor sites were closed primarily in all cases. No fistulas, stenosis/strictures, dehiscence, or swelling occurred. Pectoralis major muscle function was completely preserved in all patients.

Conclusions: The use of TAAP flap to reconstruct hypopharyngeal defect is a simple and effective method that does not require microsurgical skills. The flap is thin and pliable, with a reliable blood supply.

Level of evidence: 4. Laryngoscope, 126:1315-1320, 2016.

Keywords: Thoracoacromial artery; hypopharyngeal reconstruction; pectoralis major; pedicled flap; perforator flap.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Humans
  • Hypopharyngeal Neoplasms / surgery*
  • Hypopharynx / surgery*
  • Male
  • Middle Aged
  • Pectoralis Muscles / surgery
  • Perforator Flap*
  • Plastic Surgery Procedures / methods*
  • Thoracic Arteries / surgery*
  • Treatment Outcome