[Pharyngeal fistula after irradiation and laryngectomy. Problem of the reconstruction of the pharynx].
A 39-year-old patient with an epiglottic carcinoma stage T4N2M0 was treated initially by radiotherapy, but later underwent laryngectomy for irradiation necrosis. A pharyngeal fistula occurred in the irradiated area. After resection of the damaged skin reconstruction was performed by a double skin paddle myocutaneous pectoralis major flap. A recurrence of the fistula in the same area was closed by invagination of the flap. Three years later a massive scar stenosis developed in the reconstructed hypopharynx, so that the patient was unable to swallow. This required a total resection of the scar tissue which extended from the entrance of the hypopharynx to the upper oesophageal sphincter. The gap was bridged by a free microvascular jejunal graft. To date 6 months have elapsed since this operation and the patient is symptom free.
Piza-Katzer
H
H
Abteilung für Plastische und Rekonstruktive Chirurgie, I. Chir. Univ.-Klinik Wien.
Grasl
M C
MC
Pecoraro
K
K
Roka
R
R
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D004825:Epiglottis; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007013:Hypopharynx / Q000601:surgery; D007583:Jejunum / Q000637:transplantation; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D010608:Pharyngeal Diseases / Q000209:etiology* / Q000601:surgery; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects*; D013524:Surgical Flaps
Pharynxfistel nach Röntgenbestrahlung und Laryngektomie. Problem der Rekonstruktion des Schluckweges (Fallbericht).