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DOI: 10.1055/s-0040-1711048
Successful prevention of pharyngo-cutaneous fistula formation after salvage laryngectomy using a pectoralis major myofascial flap
Radiotherapy (RT) leads to increased tissue fibrosis and reduced vascularization. Consequently, the expected rate of pharyngo-cutaneous fistula formation after salvage total laryngectomy is about 30 %. Fistula rates can be reduced by using a pectoralis major myofascial flap (PMMF). This technique has been applied in all cases of salvage total laryngectomy over the past 5 years.
We analyzed 19 patients who underwent total laryngectomies with a PMMF after previous radiation therapy between 2014 and 2018. 79.9 % of patients were male, patient age at the time of surgery was 65.6 ± 7.9 years.
Post-operative pharyngo-cutaneous fistula rate was 15.8 % (n = 3/19) for all patients. In 2/3 patients, fistula formation was caused by tumor recurrence and no further surgical therapy was performed. One patient underwent a successful second surgery using a PMMF from the contralateral side.
Routine use of the PMMF during salvage laryngectomy successfully reduces pharyngo-cutaneous fistula rates.
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Publication History
Article published online:
10 June 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
© Georg Thieme Verlag KG
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