Thione Alessandro, Sánchez-García Alberto, Heredia-Alcalde Iván, Balaguer-Cambra Jorge, Pérez-García Alberto, Chang Edward I
Plastic and Reconstructive Surgery Department, University and Polytechnic Hospital La Fe, Avenida Fernando Abril Martorell 106, 46022 Valencia, Spain.
Department of Plastic Surgery, Division of Surgery, The University of Texas. MD Anderson Cancer Center, Houston, TX USA.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):2063-2066. doi: 10.1007/s12070-022-03449-8. Epub 2023 Apr 26.
Complex pharyngeal defects after tumor resection remain a challenging dilemma for reconstructive plastic surgeons. They often benefit from pedicled or free flaps reconstruction to maintain continuity of the aerodigestive tract and protect the great vessels. While pedicle pectoralis major myocutaneous flaps or supraclavicular flaps have been described, microvascular free flaps have largely replaced the use of pedicle flaps.
We describe our experience with subtotal and total pharyngeal reconstruction utilizing tubed DIEP (n = 2) and latissimus dorsi free flaps (n = 2). All four patients were smokers and received prior radiation.
All patients were able to resume a regular diet and did not suffer any recipient or donor site complications. There were no fistula or total flap losses.
In our experience, DIEP and latissimus dorsi free flaps can serve as a valid alternative to radial forearm, jejunal and anterolateral thigh flaps for pharyngeal reconstruction.
肿瘤切除术后复杂的咽部缺损对整形重建外科医生来说仍然是一个具有挑战性的难题。他们通常受益于带蒂或游离皮瓣重建,以维持气消化道的连续性并保护大血管。虽然已经描述了带蒂胸大肌肌皮瓣或锁骨上瓣,但微血管游离皮瓣已在很大程度上取代了带蒂皮瓣的使用。
我们描述了使用管状腹壁下动脉穿支皮瓣(n = 2)和背阔肌游离皮瓣(n = 2)进行部分和全咽重建的经验。所有四名患者均为吸烟者且之前接受过放疗。
所有患者均能够恢复正常饮食,且未出现任何受区或供区并发症。没有出现瘘管或皮瓣完全坏死的情况。
根据我们的经验,腹壁下动脉穿支皮瓣和背阔肌游离皮瓣可作为桡骨前臂皮瓣、空肠皮瓣和股前外侧皮瓣用于咽重建的有效替代方案。