loading page

Scapular Free Flap Reconstruction of Pharyngoesophageal Defects
  • +3
  • Shaum Sridharan,
  • Vaibhav Ramprasad,
  • Robert Keller,
  • Terry Day,
  • Eric J. Lentsch,
  • Judith Skoner
Shaum Sridharan
University of Pittsburgh Medical Center
Author Profile
Vaibhav Ramprasad
University of Pittsburgh Medical Center
Author Profile
Robert Keller
Medical University of South Carolina
Author Profile
Terry Day
Medical University of South Carolina
Author Profile
Eric J. Lentsch
Med Univ S Carolina
Author Profile
Judith Skoner
Medical University of South Carolina
Author Profile

Abstract

Objective:Scapular and parascapular free tissue transfer (SFTT) is a well described reconstructive option for the head and neck. Majority of reported outcomes are of reconstruction of oromandibular and midface defects. The aim was to describe one institution’s experience with SFTT for reconstruction of PE defects. Design: Retrospective review of patients undergoing SFTT for head and neck defects between 2009 and 2014 at a tertiary medical center. The cohort included patients undergoing reconstruction of PE defects with at least 6 months follow up. Setting:Tertiary medical center Participants:Patients undergoing SFTT for PE defects. Seventeen patients (13 male and 4 female) met inclusion criteria. Main outcomes and Measures: Surgical outcomes, speech, voice outcomes, swallowing outcomes, enteral feeding and tracheoesophageal puncture usage. Results:Seventeen patients met criteria – 4 female, average age at time of surgery 64.5 (SD 9.1). Thirteen patients were Caucasian and remaining four African American. Two of 17 patients developed pharyngocutaneous fistulas (PCF) as inpatients. There was one major medical complication (pulmonary embolism) and 7 minor complications. Mean hospital length of stay was 15.7 days (SD 8.2). In post-operative setting, only one patient remained PEG-dependent, 11 patients supplemented oral intake with PEG feeds and 5 patients took nutrition solely by mouth. Four patients utilized written communication exclusively, 6 patients pursued TEP placement and 7 utilized electrolarynx. Conclusion:The SFTT is a viable option for hypopharyngeal reconstruction. All SFTT remained viable for the duration of our review. Post-operative PCF rate were comparable to that reported after laryngectomy.

Peer review status:Published

01 Jun 2020Submitted to Clinical Otolaryngology
04 Jun 2020Assigned to Editor
04 Jun 2020Submission Checks Completed
05 Jun 2020Editorial Decision: Revise Minor
02 Apr 2021Published in Clinical Otolaryngology. 10.1111/coa.13777