J Reconstr Microsurg 2009; 25(9): 555-558
DOI: 10.1055/s-0029-1236833
© Thieme Medical Publishers

Reconstruction of Total Laryngopharyngectomy Defects with Deep Inferior Epigastric Perforator Flaps

Otway Louie1 , Brian Dickinson2 , Jay Granzow3 , J. Brian Boyd3
  • 1Division of Plastic Surgery, University of Washington Medical Center, Seattle, Washington
  • 2Division of Plastic Surgery, UCLA Medical Center, Los Angeles, California
  • 3Division of Plastic Surgery, UCLA Medical Center, Torrance, California
Further Information

Publication History

Publication Date:
20 August 2009 (online)

ABSTRACT

Laryngopharyngectomy reconstruction with microvascular free flaps remains challenging. Current methods of reconstruction include anterolateral thigh, radial forearm, and jejunal flaps, all of which have substantial donor site morbidity. We present a novel approach for total laryngopharyngectomy reconstruction using deep inferior epigastric perforator (DIEP) flaps. A retrospective review of head and neck reconstruction cases performed at Harbor-UCLA from 2006 to 2007 was performed. Those undergoing DIEP flaps were identified; management and postoperative course were analyzed. Two patients underwent successful reconstruction of total laryngopharyngectomy defects using DIEP flaps. Flaps up to 10 × 30 cm were harvested. Average donor vessel diameters were 2.5 cm and 3.0 cm for the artery and vein, respectively. The abdominal wounds were closed primarily. Flap survival was 100% with no emergent reexplorations. There were no postoperative bulges or hernias, and no leaks were detected on postoperative swallow evaluation. The DIEP flap is a useful addition to the armamentarium for reconstruction of total laryngopharyngectomy defects. Pedicle length is abundant, and donor vessel caliber is excellent. Large surface-area flaps can be harvested; excess flap can be deepithelialized or utilized for external skin. Primary closure of the donor site can be routinely achieved, negating the need for skin grafts.

REFERENCES

Otway Louie, M.D. 

Assistant Professor, Division of Plastic Surgery, University of Washington Medical Center

1959 NE Pacific Street, Box 356165, Seattle, WA 98195-6165

Email: olouie@u.washington.edu