the Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Laryngoscope. 2012 Mar;122(3):523-7. doi: 10.1002/lary.22477. Epub 2011 Dec 6.
OBJECTIVES/HYPOTHESIS: The aim of this study was to assess whether the use of the temporoparietal fascia as a free flap for pharyngeal closure reinforcement reduced the incidence of pharyngocutaneous fistula (PCF) in the salvage setting.
Consecutive case series.
After research ethics board approval, 12 patients who required salvage laryngectomy, including reinforcement coverage of the primarily closed pharyngeal defect with temporoparietal fascia as a free tissue transfer, were analyzed.
One (8%) out of 12 patients experienced pharyngocutaneous fistula that responded with conservative wound packing.
The PCF rate of 8% is significantly better than in similar salvage cases without flap coverage. Moreover, our PCF rate is comparable to the results shown for the pectoralis major muscle flap. The most obvious benefit of the temporoparietal fascia free flap for pharyngeal coverage in salvage laryngectomy is a reduced PCF rate with diminished donor-site morbidity, including cosmetic outcome, shoulder girdle function, and chest deformity.
目的/假设：本研究旨在评估使用颞顶筋膜作为游离皮瓣进行咽壁加固是否能降低挽救性喉切除术后咽瘘（PCF）的发生率。
连续病例系列。
经研究伦理委员会批准，对 12 例需要挽救性喉切除术的患者进行了分析，包括使用颞顶筋膜作为游离组织转移来加强原发性封闭咽缺损的覆盖。
12 例患者中有 1 例（8%）发生咽瘘，经保守性伤口填塞处理后得到缓解。
PCF 发生率为 8%，明显优于无皮瓣覆盖的类似挽救性病例。此外，我们的 PCF 发生率与胸大肌肌皮瓣的结果相当。颞顶筋膜游离皮瓣用于挽救性喉切除术中咽壁覆盖的最大益处是降低了 PCF 发生率，同时减少了供区并发症，包括美容效果、肩带功能和胸部畸形。
