J Korean Soc Plast Reconstr Surg.  2001 Jan;28(1):58-62.

Reconstruction of Pharyngocutaneous Fistula with Radial Forearm Free Flap: A Case Report

• Chung SM
• Lee OT
• Kang MS
• Chang SC

Abstract

Pharyngocutaneous fistula formation is a serious complication after total laryngectomy and its incidence varies from 7.6% to 50%. It leads to a prolonged hospitalization and complicated rehabilitation. Although many reconstruction methods have been introduced, each has its own merit and demerit and there is no single perfect answer. In our study, the fistula was reconstructed with inner lining using hinge method and radial forearm free flap. The operation was performed in 5 patients who underwent pharyngocuatneous fistula after total laryngectormy. We obtained a satisfactory reconstruction of the fistula and natural neck contouring using this method in all cases. Only 1 patient had complication of wound infection. However, the patient was healed with conservative antibiotics therapy. We believe the radial forearm free flap with hinge flap is the optimal method for circumferential reconstruction of pharyngocutaneous fistula. In comparison with other reconstructive techniques, the radial forearm free flap offers the best combination of flap reliability and low donor site morbidity. This method also allows patients to shorten the hospitalization and meet their cosmetic needs.

Keyword

Pharyngocutaneous fistula; Radial forearm free flap with hinge flap

MeSH Terms

Anti-Bacterial Agents
Fistula*
Forearm*
Free Tissue Flaps*
Hospitalization
Humans
Incidence
Laryngectomy
Neck
Rehabilitation
Tissue Donors
Wound Infection
Anti-Bacterial Agents