title: Esophageal reconstruction with larynx preservation using forearm-free flap.
abstract: Surgery for cervical esophageal malignancy frequently involves comcomitant total laryngectomy carried out because of either oncologic or functional concerns. Though uncommon, preservation of the larynx has, in recent years, been described in patients undergoing cervical esophagectomy with reconstruction of the resulting circumferential esophageal defect achieved using either free jejunal flaps or gastric pullup procedures. The use of tubed-free cutaneous flaps for circumferential cervical esophageal reconstruction, however, has been rarely described in situations where the larynx has been preserved. We describe successful use of a tubed radial forearm-free flap for reconstruction of a circumferential cervical esophageal defect with preservation of the larynx. Use of the radial forearm flap in this situation resulted in minimal donor site-related morbidity, avoided the need for laparotomy and excellent voice and swallowing function were maintained. As such, use of tubed cutaneous free flaps can be considered an option for cervical esophageal reconstruction when the larynx has been preserved.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio 43210, USA. amit.agrawal@osumc.edu
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Omar F
authors.initials: OF
authors.lastname: Husein
authors.forename: David E
authors.initials: DE
authors.lastname: Schuller
mesh_terms: D004938:Esophageal Neoplasms / Q000601:surgery*; D004944:Esophagoplasty / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D013524:Surgical Flaps