title: The use of pedicled and free flaps in laryngeal cancer recurrences: postoperative considerations and functional results.
abstract: The objective of the study was to compare the rate of complications and the functional outcomes following reconstructive surgery with pedicled and free flaps for recurrences after laryngeal cancer treatment. A retrospective analysis was conducted among the clinical records of the Department of Otolaryngology Head Neck Surgery of the University of Pavia from January 1995 to December 2004. Twenty-three patients were identified as having been reconstructed with pedicled or free flaps for hypopharyngeal recurrences after laryngeal cancer treatment. We observed a higher rate of postoperative complications after pedicled flaps (60%) than free flaps reconstructions (23%). The pedicled flaps group evidenced a longer hospitalization time (35 versus 14 days); a lower rate of patients with pedicled flaps (14% versus 69%) was able to resume a normal feeding 1 year after surgery; no patient achieved an esophageal voice, but the entire free flaps group reached an intelligible voice with the positioning of a voice prosthesis. The possibility to achieve such functional results in this kind of patient justifies the use of a surgical approach that generally requires a longer operation time than pedicled flaps, and the need for a surgical team with special skills in microsurgical techniques.
authors.affiliation: Department of Otorhinolaryngology-Head Neck Surgery, University of Pavia, I.R.C.C.S. Policlinico S. Matteo, Pavia, Italy. giulia.bertino@tin.it
authors.forename: Giulia
authors.initials: G
authors.lastname: Bertino
authors.forename: Roberto
authors.initials: R
authors.lastname: Spasiano
authors.forename: Isabella
authors.initials: I
authors.lastname: Mazzola
authors.forename: Marco
authors.initials: M
authors.lastname: Benazzo
mesh_terms: D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome