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Combined pectoralis flap and gastric pull-up for pharyngeal reconstruction
1Department of Otolaryngology, Wayne State University School of Medicine, Detroit, Michigan, USA.
Background:
The gastric transposition flap, "gastric pull-up," is one of the standard techniques of reconstruction after total laryngopharyngectomy. Under certain circumstances, this method may provide insufficient tissue for a tension-free closure. In these circumstances, the surgeon could either close under tension, risking the viability of the flap and probable fistula; create a pharyngostome; or recruit additional tissue. In this article, we describe the use of the pectoralis major myocutaneous flap in combination with the gastric pull-up for reconstruction.
Methods:
A retrospective review of three patients who underwent the procedure was performed, and a detailed description of the surgical technique is provided.
Results:
The procedure was performed in three patients, all of whom healed without wound infection or fistula.
Conclusions:
The combination of a pectoralis flap with a gastric transposition is an alternative for cases in which a gastric flap alone is insufficient. With this combination virtually any defect of the upper aerodigestive tract can be successfully closed.
