title: The role of pectoralis major myofascial flap in salvage laryngectomy: a single surgeon experience.
abstract: CONCLUSIONS
  These results support the use of a pectoralis major myofascial flap (PMMF) in patients undergoing salvage surgery.
  
  
  BACKGROUND
  Pharyngocutaneous fistula (PCF) is the most common major complication following laryngectomy. Preceding chemoradiotherapy increases the incidence and severity of PCF formation. The aim of this study was to determine whether the use of a PMMF reduces the incidence and severity of PCF formation in patients undergoing salvage surgery.
  
  
  METHODS
  This was a retrospective cohort analysis.
  
  
  RESULTS
  A total of 33 patients were identified, including 10 patients who underwent salvage surgery after chemoradiotherapy. In all, 80% of salvage surgery patients underwent PMMF reinforcement of the pharyngeal closure. A PCF rate of 50% was recorded for salvage surgery patients without PMMF reinforcement. Identical PCF rates (25%) were recorded for patients who underwent primary total laryngectomy and salvage surgery patients treated with PMMF reinforcement. Mean duration to fistula closure was 57.16 days in the primary laryngectomy group compared with 20.5 days in salvage surgery patients with PMMF reinforcement.
authors.affiliation: St James's Hospital, Dublin, Republic of Ireland. C.oosth@gmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Oosthuizen
authors.forename: David S
authors.initials: DS
authors.lastname: Leonard
authors.forename: John B
authors.initials: JB
authors.lastname: Kinsella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D017577:Cutaneous Fistula / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005402:Fistula / Q000517:prevention & control; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods*; D013524:Surgical Flaps