[Functional reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage to rehabilitate swallowing].
BACKGROUND
Patients with supraglottic laryngectomy often complain about persisting dysphagia because the resection includes the most important protective mechanisms of the airway. The additional resection of parts of the tongue base or the lateral hypopharyngeal wall leads to increasing aspiration problems.


RESULTS
Reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage in extended oro-hypopharyngeal and laryngeal carcinomas was carried out in seven patients from 1997 to 2002. In one patient, the reconstruction was performed in a second stage procedure after extended endoscopic laser resection. In four patients, the temporary tracheostomy was closed, and in five total oral feeding was possible.


CONCLUSIONS
Preliminary results show that a functional reconstruction of the supraglottic region with a free radial forearm flap and septal cartilage to reconstruct the epiglottis helps to avoid chronic aspiration and to preserve the larynx.
Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie der Martin-Luther-Universität Halle-Wittenberg. marc.bloching@medizin.uni-halle.de
M
M
Bloching
A
A
Berghaus
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002356:Cartilage / Q000637:transplantation*; D003680:Deglutition Disorders / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000534:rehabilitation*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011015:Pneumonia, Aspiration / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps / Q000294:innervation