Reconstruction of Circumferential oro- and Hypopharyngeal Defects with U-shaped Pectoralis Major Myocutaneous Flap

Abstract

OBJECTIVE: The purpose of the study was to evaluate the effectiveness of a U-shaped pectoralis major myocutaneous flap (PMMF) to reconstruct a large circumferential defect involving the oro- and hypopharynx. STUDY DESIGN AND SETTING: Retrospective case series. RESULTS: Twelve patients with advanced oro- and hypopharyngeal cancer (stage IV) underwent surgery resulting in a circumferential defect of pharyngoesophageal segment (PES). Those defects were reconstructed using a U-shaped PMMF. Four pharyngocutaneous fistulas were observed postoperatively and healed spontaneously within 3 to 7 weeks. Eight patients were able to resume a regular diet. A voice prosthesis was functional in 5 patients. CONCLUSION: This preliminary study shows that this technique is a simple and effective method with acceptable morbidity rate and satisfactory functional results. We demonstrate that this procedure allows the reconstruction of large defects involving the oro- and hypopharynx in irradiated patients. This technique could be an interesting alternative for surgical teams suffering from the absence of a microsurgical team. EBM rating: C-4