Baumann I, Maassen M M, Plinkert P K, Zenner H P
Universitäts-HNO-Klinik Tübingen.
HNO. 2002 Dec;50(12):1068-74. doi: 10.1007/s00106-002-0643-7.
Total pharyngeal reconstruction after salvage pharyngolarynectomy in recurrent tumors after primary surgery or radiation therapy may be performed by ENT surgeons in the oncologic field.
We report on six patients that underwent salvage pharyngolaryngectomy and total pharyngeal reconstruction.
In three cases pharyngeal reconstruction was performed as a two-stage procedure with deltopectoral flaps. One of these patients died before the completion of reconstruction. In three other patients the reconstruction was performed with a tubed pectoralis major myocutaneous flap including one patient after a failed reconstruction with a jejunum segment. or fistula prevention we applied silicon stents in three patients and self-expanding Nitinol stents in three other patients.
Of five successfully reconstructed patients two fed orally, one fed combined orally and via PEG and two fed via PEG.
Summarizing our experiences the use of silicon tubes and nitinol stents has proved its worth. Experiences with a larger number of patients must be collected in the future.