Surgical treatment of pharyngostomes in irradiated patients. Our experience with musculocutaneous pectoralis major flap and hyperbaric oxygen therapy.

Conclusion . Our experience confirms that pectoralis major flap is the first-choice technique for repairing recurrent hypopharyngeal fistulae in previously irradiated patients in whom microsurgical techniques are not indicated, and that hyperbaric oxygen therapy helps to solve this complex pathology...

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Publicado en:Acta Oto-Laryngologica Vol. 125; no. 7; pp. 759 - 765
Autores principales: Cordova A, Corradino B, Pirrello R, Di Lorenzo S, Dispenza C, Moschella F
Formato: Journal Article
Publicado: Taylor & Francis Ltd Jul2005
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Surgical treatment of pharyngostomes in irradiated patients. Our experience with musculocutaneous pectoralis major flap and hyperbaric oxygen therapy.
      aug:
        au:
          Cordova A
          Corradino B
          Pirrello R
          Di Lorenzo S
          Dispenza C
          Moschella F
      sug:
        subj:
          Fistula Surgery
          Hyperbaric Oxygenation
          Laryngectomy Adverse Effects
          Pectoralis Muscles Surgery
          Pharyngeal Diseases Surgery
          Surgical Flaps
          Aged
          Aged, 80 and Over
          Female
          Fistula Etiology
          Fistula Therapy
          Laryngeal Neoplasms Radiotherapy
          Laryngeal Neoplasms Surgery
          Male
          Middle Age
          Pharyngeal Diseases Etiology
          Pharyngeal Diseases Therapy
          Pharyngeal Neoplasms Radiotherapy
          Pharyngeal Neoplasms Surgery
          Postoperative Complications
          Radiotherapy, Adjuvant
          Surgery, Reconstructive Methods
          Treatment Outcomes
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Conclusion . Our experience confirms that pectoralis major flap is the first-choice technique for repairing recurrent hypopharyngeal fistulae in previously irradiated patients in whom microsurgical techniques are not indicated, and that hyperbaric oxygen therapy helps to solve this complex pathology. Objectives . A pharyngostome is a complication encountered when performing surgical operations on pharyngolaryngeal structures. The authors present their experience of treating recurrent complex pharyngostomes in previously irradiated patients in poor physical health. These patients need a simple, safe reconstruction with a low incidence of postoperative complications. Material and methods . A pedicled pectoralis major flap was used for reconstruction: the skin side of the flap was used to restore the continuity of the pharyngeal mucosa, while the muscle was used to reconstruct the intermediate layer. The skin layer was completed by means of a free skin graft. In all cases, surgical treatment was combined with hyperbaric oxygen therapy before and after the operation. Results . A total of 10 patients, all of whom had previously undergone surgery and radiotherapy, had recurring or pluri-recurring pharyngostomes. All patients (8 males, 2 females; age range 52-80 years) had previously been affected by carcinoma of the pharyngolaryngeal region. All underwent major local Ablation together with radical neck dissection and radiotherapy. In all cases there was mucosa on the posterior wall; a musculocutaneous pectoralis major flap was used in all cases for reconstruction.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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