Circumferential pharyngeal reconstruction: history, critical analysis of techniques, and current therapeutic recommendations.
Reconstruction of circumferential pharyngeal defects following total pharyngolaryngectomy presents major challenges with respect to surgical morbidity and restoration of functional deficits, which are often made more demanding by the increasing trend to utilize primary chemoradiation protocols with surgery reserved for salvage cases. The present review evaluates the reconstructive techniques described in the literature, including historical techniques as well as more recent innovative methods. Each technique is critically appraised with particular reference to postoperative morbidity and functional rehabilitation. Treatment recommendations are made based on the available evidence.
Patel
Rajan S
RS
Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. drrajanspatel@gmail.com
Goldstein
David P
DP
Brown
Dale
D
Irish
Jonathan
J
Gullane
Patrick J
PJ
Gilbert
Ralph W
RW
D002277:Carcinoma / Q000266:history / Q000601:surgery*; D019317:Evidence-Based Medicine; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000266:history / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation; D007822:Laryngeal Neoplasms / Q000266:history / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation; D009852:Omentum / Q000637:transplantation; D010369:Pectoralis Muscles / Q000637:transplantation; D010614:Pharynx / Q000601:surgery; D017410:Practice Guidelines as Topic; D019651:Plastic Surgery Procedures / Q000266:history / Q000379:methods*; D013270:Stomach / Q000637:transplantation; D013524:Surgical Flaps / Q000266:history; D016896:Treatment Outcome