Free jejunal patch graft for reconstruction after partial hypopharyngectomy with laryngeal preservation

Arch Otolaryngol Head Neck Surg. 2011 Feb;137(2):181-6. doi: 10.1001/archoto.2010.245.

Abstract

Objectives: To examine postoperative complications and swallowing function associated with free jejunal patch graft transfer after partial hypopharyngectomy with laryngeal preservation.

Design: Retrospective medical record review.

Setting: Academic research.

Patients: A consecutive series of 43 patients who underwent free jejunal patch graft transfer after partial hypopharyngectomy with laryngeal preservation composed the study sample. They represented the following 3 groups based on the type of hypopharyngeal defect: 13 patients with defects of the posterior wall (PW group), 28 patients with defects extending to the unilateral piriform sinus (PS-PW group), and 2 patients with defects extending to the bilateral piriform sinuses (PS-PS group).

Main outcome measures: Postoperative complications and oral intake ability were compared among the groups.

Results: Except for 1 patient, all the patients in the PW and PS-PS groups resumed oral intake within 2 weeks after surgery. Four patients in the PS-PW group had severe dysphagia, 2 of whom could not discontinue tube feeding.

Conclusions: Free jejunal patch graft transfer after partial hypopharyngectomy allows satisfactory swallowing function, with a low complication rate. Postoperative dysphagia was slightly more common in the PS-PW group than in the PW group.

MeSH terms

  • Carcinoma / surgery
  • Deglutition
  • Deglutition Disorders / etiology
  • Female
  • Free Tissue Flaps*
  • Humans
  • Hypopharyngeal Neoplasms / surgery*
  • Hypopharynx / surgery*
  • Jejunum / transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies