Regional pedicled flaps in prevention and repair of pharyngocutaneous fistulas

Bo Han; Zhengxue Han; Jixiang Wu; Jugao Fang

doi:10.1016/j.amjoto.2021.103119

Regional pedicled flaps in prevention and repair of pharyngocutaneous fistulas

Am J Otolaryngol. 2021 Sep-Oct;42(5):103119. doi: 10.1016/j.amjoto.2021.103119. Epub 2021 Jun 18.

Authors

Bo Han¹, Zhengxue Han², Jixiang Wu³, Jugao Fang⁴

Affiliations

¹ Department of General Surgery, Beijing TongRen Hospital, Capital Medical University, No.1 Dong Jiao MinXiang Street, Dongcheng District, Beijing City 100730, China; Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No.1 Dong Jiao MinXiang Street, Dongcheng District, Beijing City 100730, China; Department of Head and Neck Surgery, BaoTou Cancer Hospital, 18th,Tuanjie Street, Qingshan District, BaoTou, Inner Mongolia 014000, China.
² Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China.
³ Department of General Surgery, Beijing TongRen Hospital, Capital Medical University, No.1 Dong Jiao MinXiang Street, Dongcheng District, Beijing City 100730, China. Electronic address: drJixiangWu@hotmail.com.
⁴ Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, No.1 Dong Jiao MinXiang Street, Dongcheng District, Beijing City 100730, China.

PMID: 34175692
DOI: 10.1016/j.amjoto.2021.103119

Abstract

Background: Pharyngocutaneous fistula (PCF) is a common complication after laryngopharyngeal surgery. It presents incredible difficulties to both doctors and patients and can lead to prolonged hospitalization.

Objective: To analyze the pros and cons of the pedicled skin flap in the prevention and repair of PCF and put forward the authors' views and experience about the selection and application of flaps for the treatment of PCF.

Methods: A literature review of pedicled flap application in PCF was carried out.

Results: Based on the analysis of the characteristics of the pedicled flap in PCF treatment, the advantages and disadvantages are compared.

Results: In the literature, the pectoralis major myocutaneous flap is the most widely used regional pedicled flap for PCF. Many other flaps can be used to prevent and treat PCF. Each kind of pedicled flap has advantages and limitations. This plays a role in the individualized selection and design of PCF to maximize the benefits of patients.

Conclusions: Taking unity of function, aesthetics, and proficiency of operators into account, choosing the appropriate flap to repair PCF can reduce the occurrence rate of PCF and improve the patient's quality of life.

Keywords: Laryngectomy; Pedicled flap; Pharyngocutaneous fistulas.

Publication types

Review

MeSH terms

Cutaneous Fistula / prevention & control
Cutaneous Fistula / surgery*
Humans
Otorhinolaryngologic Surgical Procedures / adverse effects
Otorhinolaryngologic Surgical Procedures / methods
Pharyngeal Diseases / prevention & control
Pharyngeal Diseases / surgery*
Postoperative Complications / prevention & control
Postoperative Complications / surgery*
Quality of Life
Respiratory Tract Fistula / prevention & control
Respiratory Tract Fistula / surgery*
Surgical Flaps*
Treatment Outcome