A novel radial forearm free flap design to treat pharyngoesophageal stenosis in combination with the posterior wall of the trachea

J Surg Oncol. 2019 Dec;120(8):1446-1449. doi: 10.1002/jso.25758. Epub 2019 Nov 16.

Abstract

Pharyngoesophageal stenosis (PES) is a common and serious complication of head and neck cancer treatments such as radiation therapy, chemotherapy, tracheoesophageal puncture placement, and total laryngectomy surgery. Dilation-resistant stenosis requires surgical reconstruction, often with a radial forearm free flap (RFFF). With the present technique, the authors refine their previous bipaddled free flap design used to reconstruct a persistent tracheoesophageal fistulae (TEF) in combination with PES. Accordingly, we present a novel bipaddled triangular RFFF design ideally suited to address the shape of the defect in the posterior tracheal wall that results when the TEF is opened and the esophageal and tracheal components are restored.

Keywords: laryngeal cancer; pharyngoesophageal repair; pharyngoesophageal stenosis; pharyngoesophageal stricture; radial forearm free flap.

Publication types

  • Case Reports

MeSH terms

  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery*
  • Esophageal Stenosis / etiology
  • Esophageal Stenosis / surgery*
  • Female
  • Forearm / surgery*
  • Free Tissue Flaps*
  • Humans
  • Laryngeal Neoplasms / complications
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / adverse effects
  • Middle Aged
  • Pharyngeal Diseases / etiology
  • Pharyngeal Diseases / surgery*
  • Tracheoesophageal Fistula / etiology
  • Tracheoesophageal Fistula / surgery*