An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 2 , ISSUE 3 ( September-December, 2010 ) > List of Articles

RESEARCH ARTICLE

Liberal Use of Pectoralis Major Muscle Flap Reduces Incidence of Pharyngocutaneous Fistula Following Salvage Laryngectomy

Chris de Souza, Pankaj Chaturvedi, Shriketan Kale

Keywords : Pectoralis major myocutaneous flap,laryngectomy,pharyngocutaneous fistula

Citation Information : Souza CD, Chaturvedi P, Kale S. Liberal Use of Pectoralis Major Muscle Flap Reduces Incidence of Pharyngocutaneous Fistula Following Salvage Laryngectomy. Int J Otorhinolaryngol Clin 2010; 2 (3):253-255.

DOI: 10.5005/jp-journals-10003-1045

Published Online: 01-08-2011

Copyright Statement:  Copyright © 2010; The Author(s).


Abstract

Patients undergoing salvage laryngectomy following chemoradiotherapy are more vulnerable to develop pharyngocutaneous fistula. This is due to fibrosis and reduced vascularity that results in poor postoperative healing. We are presenting a simple technique that can reduce this distressing complication. In patients where primary closure cannot be achieved, myocutaneous flap to reconstruct the pharynx reduces the incidence of postoperative complications. Similarly, buttressing of the suture line with the pectoralis major myofacial flap has been shown to reduce the fistula rates. Needless to say that pectoralis major muscle flap is a robust flap with acceptable complication rates.


PDF Share
  1. Postoperative complications of salvage total laryngectomy. Cancer May 15, 2005;103(10):2073–81.
  2. Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: A national survey from dahanca. Head and Neck September 2003;711–16.
  3. Clinical outcomes of total laryngectomy for laryngeal carcinoma. Kathmandu University Medical Journal 2009;7(3),Issue 27,258–62.
  4. Pharyngocutaneous fistula after laryngectomy: Incidence, predisposing factors, and outcome. Arch Iranian Med 2008;11(3):314–17.
  5. A prospective study of pharyngocutaneous fistulas following total laryngectomy. J Cancer Res Ther March 2005;1(1):51–56.
  6. Prevention of wound complications following salvage laryngectomy using free vascularized issue. Head and Neck DOI 10.1002/hed May 2007; 425–30.
  7. Prevention of postlaryngectomy pharyngocutaneous fistula using a sternocleidomastoid muscle collar flap. The Journal of Laryngology and Otology 2007;121: 253–57.
  8. The sternocleidomastoid Flap: Its Indications and Limitations. Laryngoscope 2001;111:2201–04.
  9. Continuing validity of pectoralis major muscle flap 25 years after its first application. Acta Otorhinolaryngol Ital 23, 2003;297–304.
  10. Pectoralis major myofascial flap. A valuable tool in contemporary head and neck reconstruction. Head and neck; August 1997;412–18.
  11. Pectoralis myofascial flap during salvage laryngectomy prevents pharyngocutaneous fistula; Otolaryngology Head and Neck Surgery 2009;141:190–95.
  12. Prevention of postlaryngectomy pharyngocutaneous fistula: The memorial University experience. J Otolaryngol 2003;32(4):222–25.
  13. Salvage surgery for recurrent carcinoma of the hypopharynx and reconstruction using jejunal free tissue transfer and pectoralis major muscle pedicled flap; Arch Otolaryngol Head Neck Surg 2007;133:551–55.
  14. The pectoralis myofascialfflap in pharyngolaryngeal surgery after radiotherapy. Eur Arch Otorhinolaryngol 2005;262(5):357–61.
  15. The role of pectoralis major muscle flap in salvage total laryngectomy arch otolaryngol head neck surg 2009;135(10):1019–23.
  16. Prevention of unplanned pharyngocutaneous fistula in salvage laryngectomy. Otolaryngology: Head and Neck Surgery 2009;141:645–47.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.