The pectoralis myofascial flap in laryngeal surgery

Abstract

Objective: To report our experience about pedicled pectoralis major myocutaneous flap (PMMF) for the treatment of pharyngocutaneous fistula (PCF). Methods: Between June 2006 and September 2014, 202 consecutive total laryngectomies for laryngeal or hypopharyngeal squamous cell carcinoma were performed in our hospital. The medical records of the patients were retrospectively reviewed to document the development of a PCF. Results: PCF developed in 45 of 202 patients (22%) in the study group. Of these 45 patients, spontaneous closure with local wound care was achieved in 33 patients (73%). Remaining 12 patients required surgical closure with PMMF. Four of 12 patients (25%) had complications after surgical closure with PMMF. Radiotherapy had been performed before laryngectomy in 16 of 45 patients with PCF. Of these 16 patients who developed PCF and have had previous radiotherapy, spontaneous closure with local wound care was achieved in four cases, while PMMF was used in the remaining 12 cases. Conclusion: Pedicled pectoralis major myocutaneous flap is a good reconstructive option in the treatment of PCF formation following total laryngectomy surgery.

Keywords

• Pharyngocutaneous fistula, total laryngectomy, pedicled pectoralis major myocutaneous flap

Larenks cerrahisinde pektoral miyofasyal flep uygulaması

Öz

Amaç: Farengokutanöz fistül (FKF) tedavisinde pediküllü pektoralis majör miyokütanöz flep (PMMF) kullanımında edinilen tecrübelerin paylaşımı amaçlanmıştır. Yöntem: Haziran 2006 ve Eylül 2014 döneminde hastanemizde 202 ardışık larenks ve hipofarenks skuamöz hücreli karsinom larinjektomisi gerçekleştirilmiştir. Hastaların tıbbi kayıtları geçmişe dönük olarak incelenerek FKF oluşumu dokümante edilmiştir. Bulgular: Çalışma kapsamındaki 202 hastanın 45'inde (%22) FKF gelişmiştir. Bu 45 hastanın 33'ünde lokal yara bakımı ile spontane kapanma sağlanmıştır (%73). Geri kalan 12 hastaya PMMF ile cerrahi kapama yapılması gerekmiştir. Bu 12 hastadan 4'ünde PMMF ile cerrahi müdaheleden sonra komplikasyon gelişmiştir. FKF görülen 45 hastanın 16'sında larinjektomi öncesi radyoterapi uygulanmıştır. FKF gelişimi görülen ve daha önce radyoterapi uygulanan bu 16 hastadan dört vakada lokal yara bakımı ile yara kapanımı gerçekleşmiştir, geri kalan 12 vakada PMMF kullanılmıştır. Sonuç: Total larinjektomi sonrası FKF oluşumunun tedavisi için PMMF uygulaması iyi bir rekonstrüktif uygulamadır.

Anahtar Kelimeler

• Faringokutanöz fistül, total larenjektomi, pediküllü pektoralis majör myokutanöz flebi

Kaynakça

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12. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
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14. tion in any medium, provided the original work is properly cited.
15. Please cite this article as: Özkul Y, Songu M, Arslano¤lu S, Dündar R, Uçar M, Pınar E, Önal K. The pectoralis myofascial flap in laryngeal surgery. J Med
16. Updates 2014;4(3):113–116.