title: Semi-free forearm flap for pharyngeal-esophageal reconstruction after radiation therapy.
abstract: Reconstruction of the pharynx and upper esophagus uses various procedures, including pedicled or free flap. Pharyngoplasty with free forearm flap provides excellent functional results. In radiation-related pharyngeal stenosis, recipient vascularization is often poor, especially in the venous system. The authors describe pharyngeal reconstruction with semi-free forearm flap, pedicled on the cephalic vein, to minimize the risk of venous thrombosis, which is the main factor of free forearm flap necrosis. Taking the case of a laryngectomy with complete pharyngeal stenosis after radiation therapy and iterative neck surgery, the technique of pharyngeal-esophageal reconstruction by semi-free forearm flap is described in a context of impaired vascularization.
authors.affiliation: Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Pierrel
authors.affiliation: Service de Chirurgie Plastique, Esthétique et Reconstructrice, CHU de Strasbourg, Hôpital Civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Bodin
authors.affiliation: Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Schultz
authors.affiliation: Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Strasbourg, Hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France. Electronic address: agnes.dupret@chru-strasbourg.fr.
authors.forename: A
authors.initials: A
authors.lastname: Dupret-Bories
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods*; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
keywords: Antebrachial flap; Pharyngeal reconstruction; Pharyngeal stenosis; Radiation therapy