A fabricated forearm free flap with accompanying phonation tube for simultaneous reconstruction of a pharyngolaryngeal circumferential defect and voice loss1. (24th September 2012)

• Record Type: Journal Article
• Authors: Lee, Jehn‐Chuan; Hsu, Wei‐Ting; Yang, Cheng‐Chien; Chang, Shih‐Hsin
• Is Part Of: Laryngoscope. Volume 123:Number 2(2013:Feb.)
• Page Start: 344
• Page End: 349
• Publication Date: 2012-09-24
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.23631
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background:</title> <p>Total pharyngolaryngectomy is potentially ablative surgery, resulting in compromise of some most basic functions of life, including speech and swallowing. Tracheoesophageal puncture is the gold standard for voice restoration. But it still has prosthesis‐related problems.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Objectives/Hypothesis:</title> <p>We designed a uniquely customized radial forearm free flap (RFFF), which also incorporated a region for phonation tube (PT) creation, for the dual purpose of circumferential laryngopharyngeal defect reconstruction and voice production.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Methods:</title> <p>From August 2005 to September 2010, there were 18 male patients with late‐stage hypopharyngeal cancer (HPC) or laryngeal cancer (LC) who received one‐stage reconstruction with the fabricated RFFF‐accompanying PT after total pharyngolaryngectomy. We recorded the phonation outcome of phonation efficacy (PE) and maximal phonation time (MPT) postoperatively within 1 month and at least 1 year after surgery.</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Results:</title> <p>Nine patients suffered from HPC and the others suffered from LC. Twelve patients received concurrent chemoradiotherapy after surgery. The follow‐up time was 12 to 56 months (mean 28.7 months). There was no significant variance in the PE (79.72%, SD=21.93% vs. 62.50%, SD=39.60%, respectively; p = 0.115) and MPT (2.58 seconds, SD=1.80 vs. 2.97 seconds, SD=3.96, respectively; p = 0.878) between the first and last follow‐up points, even when the patients were grouped by radiotherapy status after surgery or by disease group.</p> </sec> <sec id="abs1-5" sec-type="section"> <title>Conclusions:</title> <p>The phonation outcome in our experience was satisfactory and it tolerated postoperative radiotherapy during at least the 12‐month follow‐up period.</p> </sec> </abstract>