title: Planned simultaneous cervical skin reconstruction for salvage total pharyngolaryngectomy.
abstract: BACKGROUND
  Salvage surgery after definitive radiotherapy with or without chemotherapy is still controversial, especially in cases of hypopharyngeal cancer because of the poor prognosis and surgical complications. Irradiation of the skin results in loss of flexibility of the skin and impairment of the normal healing processes, thereby increasing the risk of wound infections, which could be potentially life-threatening. In an attempt to diminish the risk of major complications, we performed planned cervical skin replacement with salvage total pharyngolaryngectomy (TPL).
  
  
  METHODS
  From 2005 to 2006, six patients underwent salvage TPL and cervical reconstruction with a deltopectoral flap at our hospital. The cervical skin replacement was determined pre-operatively and not according to the intraoperative status.
  
  
  RESULTS
  There were no major post-operative complications. Both the prolongation of the operation time and of the duration of hospitalization were within acceptable limits.
  
  
  CONCLUSIONS
  Planned cervical skin reconstruction appears to be an appropriate and acceptable procedure with salvage pharyngolaryngectomy to avoid major complications.
authors.affiliation: Department of Otolaryngology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. Quentaw@aol.com
authors.forename: Kenta
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nakao
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ebihara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujishiro
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Asato
authors.forename: Masashi
authors.initials: M
authors.lastname: Sugasawa
mesh_terms: D019072:Antibiotic Prophylaxis; D001019:Aortic Rupture / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D002339:Carotid Arteries; D062109:Dermatologic Surgical Procedures; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D010611:Pharyngectomy / Q000379:methods*; D011183:Postoperative Complications; D011832:Radiation Injuries / Q000601:surgery; D019651:Plastic Surgery Procedures; D012086:Reoperation; D016879:Salvage Therapy / Q000379:methods; D012867:Skin / Q000528:radiation effects; D013524:Surgical Flaps / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology