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Anterolateral thigh butterfly free flap for reconstruction of laryngopharyngeal defect: surgical considerations

Published online by Cambridge University Press:  07 April 2022

K B Patel Open the ORCID record for K B Patel [Opens in a new window] ,
D Silverman ,
C Barron  and
E Ozer
K B Patel
Affiliation:
Department of Head and Neck – Endocrine Oncology, H Lee Moffitt Cancer Center, Tampa, Florida, USA
D Silverman
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, James Cancer Hospital and Solove Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
C Barron
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, James Cancer Hospital and Solove Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
E Ozer*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, James Cancer Hospital and Solove Research Institute, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
*
Author for correspondence: Dr Enver Ozer, 320 W 10th Ave, B216 Starling Loving Hall, Columbus, OH 43210, USA E-mail: enver.ozer@osumc.edu Fax: +1 (614) 293 3191
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Abstract

Background

Reconstruction of a pharyngoesophageal defect remains a challenging problem, especially with involvement of the neck skin. This study aimed to demonstrate the surgical technique of utilising a butterfly modification of the anterolateral thigh flap.

Results

Reconstruction of the pharyngoesophageal defect was accomplished using the butterfly modification of the anterolateral thigh free flap. The flap was tubed on the leg while still being attached to the pedicle, to minimise the ischaemia time.

Conclusion

Butterfly anterolateral thigh free flap allows for multi-layer closure of the neopharynx and can be utilised for reconstruction of pharyngoesophageal and neck skin defects.

Keywords

LaryngectomyPharyngectomyReconstructive Surgical ProceduresFree FlapsLarynxPharynxNeoplasms, Laryngeal
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 9 , September 2022 , pp. 878 - 881
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Ozer takes responsibility for the integrity of the content of the paper

References

Durmus, K, Kakarala, K, Old, MO, Teknos, TN, Ozer, E. Anterolateral thigh butterfly free flap reconstruction for peristomal recurrence following laryngectomy: our experience in six patients. Clin Otolaryngol 2013;38:339–42CrossRefGoogle ScholarPubMed
Yu, P, Hanasono, MM, Skoracki, RJ, Baumann, DP, Lewin, JS, Weber, RS et al. Pharyngoesophageal reconstruction with the anterolateral thigh flap after total laryngopharyngectomy. Cancer 2010;116:1718–24CrossRefGoogle ScholarPubMed
Song, YG, Chen, GZ, Song, YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg 1984;37:149–59CrossRefGoogle ScholarPubMed
Bianchi, B, Ferri, A, Ferrari, S, Copelli, C, Boni, P, Ferri, T et al. The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: one surgeon's experience in 92 cases. Microsurgery 2012;32:87–95CrossRefGoogle ScholarPubMed
Genden, EM, Jacobson, AS. The role of the anterolateral thigh flap for pharyngoesophageal reconstruction. Arch Otolaryngol Head Neck Surg 2005;131:796–9CrossRefGoogle ScholarPubMed
Hanasono, MM, Skoracki, RJ, Yu, P. A prospective study of donor-site morbidity after anterolateral thigh fasciocutaneous and myocutaneous free flap harvest in 220 patients. Plast Reconstr Surg 2010;125:209–14CrossRefGoogle ScholarPubMed
Kimata, Y, Uchiyama, K, Ebihara, S, Yoshizumi, T, Asai, M, Saikawa, M et al. Versatility of the free anterolateral thigh flap for reconstruction of head and neck defects. Arch Otolaryngol Head Neck Surg 1997;123:1325–31CrossRefGoogle ScholarPubMed
Koshima, I, Fukuda, H, Utunomiya, R, Soeda, S. The anterolateral thigh flap; variations in its vascular pedicle. Br J Plast Surg 1989;42:260–2CrossRefGoogle ScholarPubMed
Lin, PY, Chen, CC, Kuo, YR, Jeng, SF. Simultaneous reconstruction of head and neck defects following tumor resection and trismus release with a single anterolateral thigh donor site utilizing a lateral approach to flap harvest. Microsurgery 2012;32:289–95CrossRefGoogle ScholarPubMed
Murray, DJ, Gilbert, RW, Vesely, MJ, Novak, CB, Zaitlin-Gencher, S, Clark, JR et al. Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube. Head Neck 2007;29:147–54CrossRefGoogle ScholarPubMed
Tan, NC, Yeh, MC, Shih, HS, Nebres, RP, Yang, JC, Kuo, YR. Single free anterolateral thigh flap for simultaneous reconstruction of composite hypopharyngeal and external neck skin defect after head and neck cancer ablation. Microsurgery 2011;31:524–8CrossRefGoogle ScholarPubMed
Yu, P. One-stage reconstruction of complex pharyngoesophageal, tracheal, and anterior neck defects. Plast Reconstr Surg 2005;116:949–56CrossRefGoogle ScholarPubMed
Revenaugh, PC, Waters, HH, Scharpf, J, Knott, PD, Fritz, MA. Suprastomal cutaneous monitoring paddle for free flap reconstruction of laryngopharyngectomy defects. JAMA Facial Plast Surg 2013;15:287–91CrossRefGoogle ScholarPubMed
Akin, S, Basut, O. A new flap design for monitoring the circulation of a buried free radial forearm flap in pharyngoesophageal reconstruction. J Reconstr Microsurg 2002;18:591–4CrossRefGoogle ScholarPubMed
Furuta, S, Hataya, Y, Ishigaki, Y, Watanabe, T. Monitoring the free radial forearm flap in pharyngo-oesophageal reconstruction. Br J Plast Surg 1997;50:40–2CrossRefGoogle ScholarPubMed
Urken, ML, Weinberg, H, Vickery, C, Buchbinder, D, Biller, HF. Free flap design in head and neck reconstruction to achieve an external segment for monitoring. Arch Otolaryngol Head Neck Surg 1989;115:1447–53CrossRefGoogle ScholarPubMed
Punthakee, X, Zaghi, S, Nabili, V, Knott, PD, Blackwell, KE. Effects of salivary bypass tubes on fistula and stricture formation. JAMA Facial Plast Surg 2013;15:219–25CrossRefGoogle ScholarPubMed

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