title: Reconstruction of pharyngeal defects with a submental island flap after hypopharyngeal carcinoma ablation.
abstract: OBJECTIVE
  This study aimed to evaluate the oncologic and functional results of pharyngeal defect reconstruction using a submental island flap in hypopharyngeal cancer patients.
  
  
  METHODS
  Functional and oncologic results were assessed in 14 patients based on a retrospective chart review. Speech function grading was as follows: 1 = excellent (>70% intelligibility); 2 = good (40-70% intelligibility), and 3 = poor (<40% intelligibility). Swallowing function score was stratified as 1 = full diet (excellent), 2 = soft diet (excellent-good), 3 = liquid diet (good), 4 = combined oral and gastric tube (good-poor), and 5 = gastric tube-dependent (poor).
  
  
  RESULTS
  All flaps survived well. Salivary fistula with infection was found in 1 patient and treated conservatively. The mean length of hospitalization, and speech and swallowing scores according to laryngeal invasion in 11 patients after partial pharyngectomy were 21.63 ± 4.31 versus 11 ± 2.00 (p = 0.003), 2.38 ± 0.5 versus 1.67 ± 1.16 (p = 0.18) and 3.88 ± 0.84 versus 3.33 ± 1.53 (p = 0.46), respectively. Speech and swallowing returned to good-excellent in 63.6% and good in 45.5% of patients after surgery.
  
  
  CONCLUSIONS
  The submental island flap is reliable for reconstructing laryngopharyngeal defects after ablation of hypopharyngeal cancer. Speech and swallowing are restored to good function in half of the patients. Laryngeal involvement of the cancer is predictive of longer hospitalization.
authors.affiliation: Department of Otolaryngology, Cathay General Hospital, Taipei, Taiwan, ROC. ent.taiwan@gmail.com
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Wang
authors.forename: Tzer-Zen
authors.initials: TZ
authors.lastname: Hwang
authors.forename: Chia-Hao
authors.initials: CH
authors.lastname: Chang
authors.forename: Yen-Chun
authors.initials: YC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D003679:Deglutition; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps