Reconstruction of Glottis and Hyoppharynx using Radial Forearm - Palmaris Longus Composite Free Flap.

Lee, Choong Jae; Lee, Han Sol; Gil, Minn Seok; Cho, Jung Il; Kim, Young Mo; Lee, Se Il

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2000;27(6):581-586.
Published online November 1, 2000.

Reconstruction of Glottis and Hyoppharynx using Radial Forearm - Palmaris Longus Composite Free Flap.

Choong Jae Lee, Han Sol Lee, Minn Seok Gil, Jung Il Cho, Young Mo Kim, Se Il Lee

¹Department of Plastic and Reconstructive Surgery, College of Medicine, Inha University. cjlee313@inha.ac.kr
²Department of Otorhinolaryngology, College of Medicine, Inha University.

Abstract

Partial laryngectomy and pharyngectomy have been suggested for localized hypopharyngeal cancer to preserve the function of larynx. In case of limited partial laryngectomy, local soft tissue flaps are sufficient to provide adequate bulk for glottic closure. However, in case of extensive partial laryngectomy procedure in which more cartilaginous framework is resected, we feel an increased necessity of considering 'hard tissue' as well as soft tissue restoration to prevent airway collapse and glottic incompetency. We have tried radial forearm free flap including palmaris longus tendon for reconstruction of glottis and hypopharynx following a wide vertical hemilaryngopharyngectomy. We had 2 patients with hypopharyngeal cancers localized in pyriform sinus. The tendon was secured so as to drill holes in the cricoid and thyroid cartilage at the glottic level to help maintain the position of soft tissue lining and sewe as buttress for mobile vocal cord. A good restored phonation and respiration were obtained in two cases of hypopharyngeal cancer patients. But one patient suffered from frequent aspiration due to esophageal inlet stricture after radiation therapy.

Keywords: Hypopharygeal cancer; Partial laryngectomy; Radial forearm free flap; Palwmaris longus tendon