Reconstruction of defects following surgery for hypopharyngeal carcinoma using artificial biological material

Use of artificial biological material – acellular dermal matrix (Alloderm, ADM) – combined with pectoralis major myocutaneous flaps (PMMFs) or other cervical tissue is a feasible technique with which to reconstruct a large circumferential defect involving the oral cavity and hypopharynx.

This paper presents a review of seven patients with advanced hypopharyngeal carcinoma treated at Tianjin Medical University Cancer Institute & Hospital, China, over a 4-year period.

ADM was used in the form of tissue patches for reconstruction. Five of the seven patients underwent total laryngectomy and total hypopharyngectomy, and reconstruction with a combination of PMMF and ADM tissue patches to restore hypopharyngeal functions. Two other patients underwent tumour resection. The defect in the posterior pharyngeal wall was reconstructed with ADM. Treatment details of the seven patients are discussed.

All five PMMFs and seven ADM tissue patches survived. No pharyngeal fistula occurred. Satisfactory healing was observed between the wound margin and ADM 10 days after operation. The trauma area was completely covered by growing epithelium 18–37 days after operation. To some degree, stenosis of the pharyngeal cavity did occur, but patients could have a regular diet following dilatation of the stenosis. Five patients are free of disease after 18–42 months of follow-up.