A Technique for Bulk Adipofascial Free Tissue Reconstruction of a Recurrent Pharyngoesophageal Injury in the Setting of Failed Anterior Cervical Hardware. (23rd March 2022)

• Record Type: Journal Article
• Authors: Shah, Shreni N.; Khan, Mahnoor; Sharma, Abhay; Padhya, Tapan A.; Mifsud, Matthew J.
• Is Part Of: Craniomaxillofacial research & innovation. Volume 7(2022)
• Publication Date: 2022-03-23
• Subjects: free tissue reconstruction -- pharyngoesophageal fistula -- anterior cervical fusion -- cervical hardware -- adipofascial flap -- anterolateral thigh flap; Face -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Head -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.51
• DOI: 10.1177/27528464221078457
• Languages: English
• ISSNs: 2752-8464

Abstract

Study Design: Technical Note Objective: Pharyngoesophageal injury in the setting of previous anterior cervical discectomy and fusion (ACDF) is a devastating complication with no standard corrective treatment protocol. Reconstruction can thus be a complex endeavour often leading to treatment failure, recurrent pharyngoesophageal fistula and need for multiple surgical procedures. The authors present our novel approach to free tissue reconstruction of these injuries. Methods: We utilized a bulk adipofascial flap to completely obliterate the retropharyngeal space and correct the pharyngoesophageal defect. Results: An adipofascial flap facilitates complete separation of the injured pharyngeal/oesophageal mucosa form the cervical spine and any retained hardware. Conclusions: In our hands, this technique has allowed successful repair of complex pharyngoesophageal injuries after previous ACDF procedures which includes resumption of normal oral intake.