Priliminary study of pedicled sternocleidomastoid clavicular periosteocutaneous flap to repair the laryngotracheal defect / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the feasibility of utilizing pedicled sternocleidomastoid clavicular periosteocutaneous flap to reconstruct the laryngotracheal defect after tumor resection.@*METHOD@#To review 6 cases of laryngotracheal defect resulting from resction of thyroid papillary carcinoma(4/6) or subglottic laryngeal carcinoma (2/6) (T1~2N1~2M0 , UICC,2002), laryngotracheal stenting was also employed in all cases. Half a year after surgery, the stoma was sutured if no local recurrence took place and safety was proved after tracheal tube had been obstructed for days. The follow-up time lasted from half a year to 3 years.@*RESULT@#Four cases (4/6) were extubated successfully without event, one case could intermittently plug the tracheal tube. One patient couldn't breath with tracheal tube plugging.@*CONCLUSION@#To reconstruct the laryngotracheal defect with pedicled sternocleidomastoid clavicular.periosteocutaneous flap after tumor resection is feasible in selected cases and could get satisfactory clinical results either in respiration or phonation.

Laryngo-tracheal flap to reconstruct the defect after resection of the hypopharyngeal carcinoma with cervical esophagus involvement / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate cervical esophageal reconstruction by means of laryngo-tracheal flap after resection of hypopharyngeal carcinoma with cervical esophageal involvement.@*METHOD@#Eleven cases of hypopharyngeal carcinoma with cervical esophageal involvement. Unilateral piriform sinus and cervical esophagus were involved in 8 cases (8/11) while bilateral piriform sinus, posterior pharyngeal wall and cervical esophagus were involved in 3 cases. After resection of laryngeal, pharyngeal and esophageal tumors and bilateral neck dissection, direct anastomosis of larynx and trachea with esophagus of cervico-thoracic segment was performed if circular structure of larynx and trachea could be preserved (3/11), pectoralis major myocutaneous flap was employed if only part of pharynx and larynx could be preserved (8/11). Postoperative radiochemotherapy was adopted and follow-up lasted for 1-5 years.@*RESULT@#All cases healed without event except for one case of pharyngeal fistula and one case of chylous fistula which also healed after about 2 weeks dressing change. All patients got normal diet without anastomotic stricture. There was no recurrence in 6 patients at the 3 years follow-up, 4 patients had metastases in the neck and 1 patient had thoracic esophageal carcinoma with hepatic metastasis arid gave up further treatment. The overall 3-year survival rate was 54.5%.@*CONCLUSION@#Using laryngo-tracheal flap to reconstruct cervical esophagus after resection of hypopharyngeal carcinoma with cervical esophageal involvement is a recommendable method that is simple in processing, reliable in effect and less in postoperative complications.