Using a Sternocleidomastoid Muscle Flap to Close an Iatrogenic Tracheoesophageal Fistula in a Patient With Advanced Laryngeal Cancer: A Case Report and Literature Review

Ann Plast Surg. 2019 Jan;82(1S Suppl 1):S126-S129. doi: 10.1097/SAP.0000000000001718.

Abstract

Background: An iatrogenic tracheoesophageal (TE) fistula is one possible complication after total laryngectomy with flap reconstruction. We used sternocleidomastoid (SCM) rotation flap to close a TE fistula.

Methods and results: A 69-year-old man with laryngeal cancer underwent total laryngectomy with radial forearm free flap reconstruction. A tracheostoma stenosis was noticed 7 months after the tracheostomy tube was removed. The patient underwent tracheostoma dilatation; the iatrogenic TE fistula was noticed 1 month later. We used SCM rotation flap to close the TE fistula. The postoperative course was uneventful. A barium esophagogram showed no leakage in the esophagus.

Conclusions: Tracheoesophageal fistula can be reconstructed with an SCM rotation flap. If the TE fistula is of a suitable size, this reconstructive strategy is effective and simple to close persistent TE fistula and avoid further airway complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Follow-Up Studies
  • Humans
  • Iatrogenic Disease
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / adverse effects*
  • Laryngectomy / methods
  • Male
  • Myocutaneous Flap / blood supply
  • Myocutaneous Flap / transplantation*
  • Neck Muscles / surgery*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Tomography, X-Ray Computed / methods
  • Tracheoesophageal Fistula / diagnostic imaging
  • Tracheoesophageal Fistula / etiology
  • Tracheoesophageal Fistula / surgery*
  • Tracheostomy / adverse effects*
  • Tracheostomy / methods
  • Treatment Outcome