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December 1988

Pectoralis Major Myocutaneous Flap Reconstruction for Laryngopharynx and Cervical Esophagus

Author Affiliations

Columbus, Ohio

Arch Otolaryngol Head Neck Surg. 1988;114(12):1364-1365. doi:10.1001/archotol.1988.01860240014006

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At the 91st Annual Meeting of the Triological Society in Palm Springs, Fla, Richard L. Fabian, MD, Harvard Medical School, Boston, reported reconstructing the hypopharynx and cervical esophagus with the pectoralis major myocutaneous flap. He sought to determine whether or not a one-stage reconstruction could be achieved utilizing this approach. Twenty-two patients were included in his analysis, which included five patients who had an esophageal stenosis following laryngectomy and 17 patients who underwent primary reconstruction after extended laryngectomy. Analysis of results demonstrated that preoperative radiation therapy did contribute to a somewhat more complicated postoperative course. The technique involves partially placing a tube in the skin island of the flap and suturing it to the remaining pharyngeal mucosa, then using a salivary bypass tube to place a stent in the area. The lower incidence of failure and complete absence of mortality prompted Dr Fabian to conclude that this is a viable

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