title: The fabricated radial forearm flap in pharyngolaryngeal surgery: saliva leakage and its prevention.
abstract: Reconstruction of the circular pharyngo-oesophageal defect continues to represent a formidable challenge for the head and neck surgeon. The fabricated radial forearm flap can provide thin and pliable skin and has potential in this one-stage reconstructive surgery. However, major problems with this technique are saliva leakage, fistula formation and stricture of the oesophageal anastomosis. Our experience with this flap for 11 pharyngo-oesophageal reconstructions has given us a better understanding of how to prevent these complications. Fistula formation and stricture were problems in our first two cases. With the 9 following cases, prevention of these complications was achieved by positioning the T-shaped suture lines of the tubed flap posteriorly. Our results suggest that adequate protection of the T-shaped suture lines during fabrication and anastomosis of the forearm flap is important in the prevention of saliva leakage.
authors.affiliation: Department of Otolaryngology, Chang Gung Medical College, Kaohsiuing Medical Center, Hsien, Taiwan.
authors.forename: C Y
authors.initials: CY
authors.lastname: Su
authors.forename: Y C
authors.initials: YC
authors.lastname: Chiang
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004940:Esophageal Stenosis / Q000150:complications; D004947:Esophagus / Q000601:surgery; D005260:Female; D005402:Fistula / Q000150:complications; D005542:Forearm; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000150:complications; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy; D011183:Postoperative Complications / Q000517:prevention & control*; D012463:Saliva / Q000378:metabolism; D013524:Surgical Flaps