Semi-free forearm flap for pharyngeal-esophageal reconstruction after radiation therapy - 28/03/15

Doi : 10.1016/j.anorl.2014.09.002

C. Pierrel ^a, F. Bodin ^b, P. Schultz ^a, A. Dupret-Bories ^a,^⁎
^a Service d’ORL et de Chirurgie Cervico-Faciale, CHU de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
^b Service de Chirurgie Plastique, Esthétique et Reconstructrice, CHU de Strasbourg, Hôpital Civil, 1, place de l’Hôpital, BP 426, 67091 Strasbourg cedex, France

^⁎Corresponding author.

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Abstract

Reconstruction of the pharynx and upper esophagus uses various procedures, including pedicled or free flap. Pharyngoplasty with free forearm flap provides excellent functional results. In radiation-related pharyngeal stenosis, recipient vascularization is often poor, especially in the venous system. The authors describe pharyngeal reconstruction with semi-free forearm flap, pedicled on the cephalic vein, to minimize the risk of venous thrombosis, which is the main factor of free forearm flap necrosis. Taking the case of a laryngectomy with complete pharyngeal stenosis after radiation therapy and iterative neck surgery, the technique of pharyngeal-esophageal reconstruction by semi-free forearm flap is described in a context of impaired vascularization.

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Keywords : Antebrachial flap, Pharyngeal reconstruction, Pharyngeal stenosis, Radiation therapy