title: Reconstruction of the larynx and aryepiglottic fold using a free radial forearm tendocutaneous flap after partial laryngopharyngectomy: a case report.
abstract: The patient was a 62-year-old man with chief complaints of pharyngeal pain and dysphagia. He was diagnosed with pyriform sinus poorly differentiated squamous cell carcinoma T3N0M0 (Stage II) and underwent partial laryngopharyngectomy, lymphadenectomy in the right neck, tracheostomy, and reconstruction of the larynx and aryepiglottic fold with a free radial forearm flap and the associated vascularized palmaris longus tendon. No particular problems occurred after surgery, and swallowing and articulation functions were successfully recovered. A free jejunum transfer is the first choice for reconstruction of a defect after partial hypopharyngectomy, but reconstruction of the supracricoid complex structure of the larynx using a free jejunum transfer after partial laryngopharyngectomy may lead to aspiration of intestinal fluids. In this case, we performed functional reconstruction of the laryngopharyngeal defect using a free radial forearm flap including a vascularized tendon of the palmaris longus, and satisfactory postoperative function was achieved. We believe that the key to successful functional recovery after partial laryngopharyngectomy is establishment of the three-dimensional complex structure of the arytenoid and aryepiglottic fold.
authors: Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Tokyo, Tokyo, Japan. mihara@keiseigeka.name
authors: Makoto
authors: M
authors: Mihara
authors: Takuya
authors: T
authors: Iida
authors: Hisako
authors: H
authors: Hara
authors: Yohei
authors: Y
authors: Hayashi
authors: Takumi
authors: T
authors: Yamamoto
authors: Narushima
authors: N
authors: Mitsunaga
authors: Takeshi
authors: T
authors: Todokoro
authors: Gentaro
authors: G
authors: Uchida
authors: Isao
authors: I
authors: Koshima
mesh_terms: D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D058752:Free Tissue Flaps; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007821:Laryngeal Muscles / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000379:methods; D056144:Pyriform Sinus; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013536:Suture Techniques