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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2001;28(1):58-62.
Published online January 1, 2001.
Reconstruction of Pharyngocutaneous Fistula with Radial Forearm Free Flap: A Case Report.
Seung Moon Chung, One Tech Lee, Moo Suk Kang, Suk Choo Chang
Department of Plastic and Reconstructive Surgery, College of Medicine, Kosin University, Pusan, Korea.
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.
Keywords: Pharyngocutaneous fistula; Radial forearm free flap with hinge flap
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