title: Temporoparietal fascia free flap for pharyngeal coverage after salvage total laryngectomy.
abstract: OBJECTIVE
  The aim of this study was to assess whether the use of the temporoparietal fascia as a free flap for pharyngeal closure reinforcement reduced the incidence of pharyngocutaneous fistula (PCF) in the salvage setting.
  
  
  METHODS
  Consecutive case series.
  
  
  METHODS
  After research ethics board approval, 12 patients who required salvage laryngectomy, including reinforcement coverage of the primarily closed pharyngeal defect with temporoparietal fascia as a free tissue transfer, were analyzed.
  
  
  RESULTS
  One (8%) out of 12 patients experienced pharyngocutaneous fistula that responded with conservative wound packing.
  
  
  CONCLUSIONS
  The PCF rate of 8% is significantly better than in similar salvage cases without flap coverage. Moreover, our PCF rate is comparable to the results shown for the pectoralis major muscle flap. The most obvious benefit of the temporoparietal fascia free flap for pharyngeal coverage in salvage laryngectomy is a reduced PCF rate with diminished donor-site morbidity, including cosmetic outcome, shoulder girdle function, and chest deformity.
authors.affiliation: the Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. kevin.higgins@sunnybrook.ca
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Higgins
authors.forename: Bruce
authors.initials: B
authors.lastname: Ashford
authors.forename: Boban M
authors.initials: BM
authors.lastname: Erovic
authors.forename: John
authors.initials: J
authors.lastname: Yoo
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Enepekides
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017577:Cutaneous Fistula / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D005205:Fascia / Q000637:transplantation*; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D015994:Incidence; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D016156:Respiratory Tract Fistula / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome