Continental Preferences in Reconstruction of Pharyngolaryngectomy Defects: A Multi-National Survey

Objectives: Reconstruction of total pharyngolaryngectomy defects may restore pharyngeal function and enable tracheoesophageal speech after resection of locoregionally advanced malignancy. Little remains known about variations in the practices and preferences of surgeons across differing global regions.

Methods: A survey was sent to reconstructive head and neck surgeons across three continents with responses analyzed to evaluate trends.

Results: Of 155 respondents, 79.4% (n = 123) completed the survey including surgeons from North America (USA/Canada), the Indian Subcontinent (India/Bangladesh) and Australia/New Zealand. Among surgeons trained in pedicle flap reconstruction, only 47.5% performed these procedures after completion of training. Pedicle flaps were performed most frequently by surgeons from the Indian subcontinent. The anterolateral thigh flap was most popular among surgeons for free flap reconstruction, 58.5% (n = 72).

Conclusion: This study demonstrates significant region-based variation in preferred reconstructive modality, suggesting location of practice and institutional experience influence the reconstructive algorithms of head and neck surgeons.