Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer.
BACKGROUND
Patients afflicted with advanced hypopharyngeal cancer must contend with both potentially poor survival prognosis and a compromised quality of remaining life. After extensive ablative surgery, it is imperative to use a reliable, low morbidity reconstructive strategy that will allow for an expedient reconstitution of speech and swallowing.


METHODS
Retrospective review of the records of 28 patients who underwent pharyngoesophageal reconstruction with radial forearm free flaps (RFFF) between 1996 and 2001 by a single surgeon (RE). Analysis was confined to patients requiring complete tubulation of the RFFF. Perioperative mortality, morbidity, and functional evaluation based on the parameters of speech and swallowing were analyzed.


RESULTS
Completely tubulated RFFF were required in 25 patients. There was 100% RFFF survival with no perioperative mortalities. The median hospital stay was 8.0 days. All patients acquired a reconstitution of oral alimentation; median time to swallowing was 18.0 days. Fourteen of 16 patients (93%) were able to rely on TEP speech as their main modality of communication. Two patients (8%) had early fistulas develop, and 5 (20%) had late fistulas develop. Nine patients (36%) required mechanical dilatation; five of the nine patients required only one dilatation.


CONCLUSIONS
Review of our experience has confirmed the reliability and excellent functional outcome associated with this flap.
Scharpf
Joseph
J
Department of Otolaryngology and Communicative Disorders, A71, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Esclamado
Ramon M
RM
D000368:Aged; D003679:Deglutition / Q000502:physiology; D004564:Electrocoagulation; D005260:Female; D005542:Forearm / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology; D013524:Surgical Flaps / Q000502:physiology*; D013997:Time Factors