A technique for pharyngeal reconstruction in heavily irradiated patients.

A technique for esophageal reconstruction using a staged deltopectoral tubed, pedicled flap has been highly successful in irradiated patients. The basic principle involves use of the neck skin as the posterior wall and the dorsal and lateral aspects of the tubed flap to form the anterior and lateral walls of the newly constructed pharynx. The ventral surface forms the cutaneous covering. The submental area and base of tongue are used for implantation of the distal end of the flap, taking advantage of the abundant blood supply of this area. It is a fail-safe method of reconstruction, particularly applicable in cases in which the local skin is of poor quality.