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Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy

Published online by Cambridge University Press:  08 August 2016

S Sharma ,
D A Chaukar ,
S G Laskar ,
N Kapre ,
A Deshmukh ,
P Pai ,
P Chaturvedi  and
A D'Cruz
S Sharma
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
D A Chaukar*
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
S G Laskar
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
N Kapre
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
A Deshmukh
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
P Pai
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
P Chaturvedi
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
A D'Cruz
Affiliation:
Department of Head Neck Services, Tata Memorial Hospital, Mumbai, India
*
Address for correspondence: Dr D Chaukar, 1226 Homi Bhabha Block, Dr E Borges Marg, Tata Memorial Hospital, Parel, Mumbai 400012, India Fax: +91 24146937 E-mail: dchaukar@gmail.com
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Abstract

Objective:

This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy.

Methods:

A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay.

Results:

The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43.6 per cent; onlay flap group, 41.9 per cent; p = 0.8). Fistulae in the onlay flap group healed faster: the median and mean fistula duration were 37 and 55 days, respectively, in the primary closure group and 20 and 25 days, respectively, in the onlay flap group (p = 0.008).

Conclusion:

Use of an onlay pectoralis major myofascial flap did not decrease the pharyngocutaneous fistula rate, although fistula duration was shortened. A well-designed randomised-controlled trial is needed to establish parameters for its routine use in clinical practice.

Keywords

FistulaLaryngectomySurgical Flaps
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 9 , September 2016 , pp. 860 - 864
Copyright
Copyright © JLO (1984) Limited 2016 

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Footnotes

Presented as an oral paper at the joint Fifth World Congress of the International Federation of Head and Neck Oncologic Society and 2014 Annual Meeting of the American Head and Neck Society, 29 July 2014, New York, USA

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