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Radial forearm free flap pharyngoesophageal reconstruction
B Azizzadeh1, S Yafai, J D Rawnsley
1University of California Los Angeles School of Medicine, Los Angeles, CA 90095, U.S.A.
The Laryngoscope
|May 19, 2001
Summary
Radial forearm free flaps offer reliable pharyngoesophageal reconstruction after laryngopharyngectomy, enabling good speech and swallowing outcomes. However, a notable incidence of pharyngocutaneous fistulas can delay oral intake.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Microsurgery
Background:
- Laryngopharyngectomy necessitates pharyngoesophageal reconstruction.
- Radial forearm free flaps (RFFFs) are a reconstructive option.
Purpose of the Study:
- To evaluate RFFFs for pharyngoesophageal reconstruction post-laryngopharyngectomy.
- Assess outcomes regarding wound healing, speech, and swallowing.
Main Methods:
- Retrospective review at a tertiary academic center.
- Analysis of 20 patients undergoing RFFF reconstruction.
Main Results:
- Successful flap transfer in all patients.
- 85% resumed oral diet; 20% experienced pharyngocutaneous fistulas.
- 20% developed distal strictures; 5 patients achieved useful tracheoesophageal speech.
Conclusions:
- RFFFs provide reliable reconstruction with good speech and comparable swallowing outcomes to jejunal flaps.
- Advantages include flap reliability and donor site advantages.
- Pharyngocutaneous fistulas are a drawback, potentially delaying oral intake.