Department of Head and Neck Surgery, Amrita Institute of medical Sciences, Kochi, Kerala, India.
Head Neck. 2013 Feb;35(2):E60-3. doi: 10.1002/hed.21872. Epub 2011 Oct 22.
Tracheoesophageal puncture (TEP) combined with a voice prosthesis is commonly used for voice production in postlaryngectomy patients. In certain cases, however, leakage occurs around the prosthesis. Many techniques have been described to correct this problem. Surgical closure of the puncture site has to be done if the conservative techniques fail. We present the use of the pedicled deltopectoral flap on the basis of a single perforator in the closure of these fistulae.
The reported technique was used in 6 patients over a period 8 years from 2004 to 2011.
The technique was successful in 5 patients. In 1 case there was dehiscence at the leading edge of the flap because of severe local wound infection.
The novel technique described by us avoids the need for layered closure or dissection of the trachea and esophagus. It is simple and reliable and provides durable results.
气管食管造瘘术（TEP）联合人工发声管通常用于喉切除术后患者的发声。然而，在某些情况下，人工发声管周围会发生渗漏。已经描述了许多技术来纠正这个问题。如果保守治疗失败，就必须进行造瘘口的手术闭合。我们提出了一种基于单一穿支血管的带蒂肩胛胸肌皮瓣在这些瘘管闭合中的应用。
自 2004 年至 2011 年的 8 年间，我们在 6 例患者中应用了该技术。
该技术在 5 例患者中取得了成功。在 1 例患者中，由于严重的局部伤口感染，导致皮瓣前缘裂开。
我们描述的新技术避免了气管和食管的分层闭合或分离。它简单可靠，可获得持久的效果。
