Institutional experience with total pharyngectomy reconstruction: Exploring the role of the salivary bypass tube.

BACKGROUND: There is a lack of consensus regarding the effectiveness of salivary bypass tubes during total pharyngectomy reconstruction to prevent pharyngocutaneous fistula or pharyngoesophageal stricture. METHODS: Our study examined tubed free flap reconstruction outcomes for total pharyngectomy defects over 11 years at a single tertiary referral center. We compared postoperative fistula and stricture rates between two groups: those with salivary bypass tubes inserted during reconstruction and those without. RESULTS: Among 36 patients, 26 had radial forearm, and 10 had anterolateral thigh free flap reconstruction. 53% received salivary bypass tubes. However, the tubes did not significantly reduce the relative risks of fistula or stricture. Notably, neck dissection during total pharyngectomy was associated with increased fistula incidence. Minor salivary bypass tube-related complications affected 21% of subjects. CONCLUSION: The role of salivary bypass tubes in total pharyngectomy reconstruction remains uncertain.

Lande subtraction method with finite integration limits and application to strong-field problems.

The Lande subtraction method has been widely used in Coulomb problems, but the momentum coordinate p∈(0,∞) is assumed. In past applications, a very large range of p was used for accuracy. We derive the supplementary formulation with p∈(0,p_{max}) at reasonably small p_{max} for practical calculations. With the recipe, accuracy of the hydrogenic eigenspectrum is dramatically improved compared to the ordinary Lande formula by the same momentum grids. We apply the present formulation to strong-field atomic above-threshold ionization and high-order harmonic generations. We demonstrate that the proposed momentum space method can be another practical theoretical tool for atomic strong-field problems in addition to the existing methods.