Comparison of the outcomes of anterolateral thigh flap and peroneal flap in total laryngectomy reconstruction

Yu-Hsuan Hsieh; I-Wen Chen; Cheng-Ta Lin; Kuo-Chung Yang; Wen-Chung Liu; Ching-Ching Chiu; Shih-Yu Lee; Lee-Wei Chen

doi:10.1002/lio2.1062

Comparison of the outcomes of anterolateral thigh flap and peroneal flap in total laryngectomy reconstruction

Laryngoscope Investig Otolaryngol. 2023 Apr 20;8(3):645-650. doi: 10.1002/lio2.1062. eCollection 2023 Jun.

Authors

Yu-Hsuan Hsieh^{1

2

3}, I-Wen Chen⁴, Cheng-Ta Lin^{5

6}, Kuo-Chung Yang^{1

2}, Wen-Chung Liu^{1

2

3}, Ching-Ching Chiu⁷, Shih-Yu Lee¹, Lee-Wei Chen^{1

2}

Affiliations

¹ Division of Plastic and Reconstructive Surgery, Department of Surgery Kaohsiung Veterans General Hospital Kaohsiung City Taiwan.
² School of Medicine College of Medicine, National Yang Ming Chiao Tung University Taipei Taiwan.
³ School of Medicine College of Medicine, National Sun Yat-sen University Kaohsiung City Taiwan.
⁴ Department of Pediatrics Kaohsiung Veterans General Hospital Kaohsiung City Taiwan.
⁵ Division of Plastic Surgery Chi Mei Medical Center Liouying Taiwan.
⁶ School of Dentistry and Institute of Oral Medicine College of Medicine, National Cheng Kung University Tainan Taiwan.
⁷ Department of Otolaryngology Kaohsiung Veterans General Hospital Kaohsiung City Taiwan.

Abstract

Background: We usually use an ALT or peroneal flap in total laryngectomy reconstruction, depending on the surgeons' preference. No direct comparison of the outcomes of the ALT flap and peroneal flap exists.

Methods: From 2014 to 2022, we reviewed patients who had total laryngectomy and were reconstructed with an ALT flap and peroneal flap. Patient characteristics and surgical outcomes were collected and compared.

Results: The peroneal group had a significantly higher risk of neopharynx leakage (40% vs. 13.2%, p = .020) and late pharyngocutaneous fistula formation (30% vs. 5.3%, p = .009) than the ALT group. Peroneal flap was found to be the only independent risk factor for neopharynx leakage (p = .025, odds ratio [OR] = 5.5) and late pharyngocutaneous fistula formation (p = .02, OR = 7.7) in multivariate logistic regression.

Conclusion: In the reconstruction of total laryngectomy, the ALT flap is preferable over the peroneal flap.

Keywords: cancer; laryngectomy; peroneal flap; pharyngoesophageal; reconstruction.