Results after U-shaped Pectoralis Major Myocutaneous Flap Reconstruction of Circumferential Pharyngeal Defects

Abstract

Objectives:

Evaluate surgical, functional, carcinologic results after circumferential pharyngolaryngectomy and reconstruction with U-shaped pectoralis major myocutaneous flap.

Methods:

Forty-one patients in a retrospective case series spanning a 6-year period.

Results:

General and local complications occurred in 10% and 22% of patients respectively, without early death. Swallowing and vocal functions were satisfactory for 82% and 43% of patients respectively, despite 39% of neopharynx stricture and 22% of pharyngocutaneous fistula. With a 20-month mean follow-up, cancer recurrence was present in 58% of patients. The overall survival rate was 29% at 3 years.

Conclusions:

This flap is simple, reliable, and allows adequate reconstruction of the hypopharynx. However, the neopharynx stricture rate is high and the quality of voice rehabilitation is poor when compared with free flaps. This procedure, which is an option for the reconstruction of circumferential pharyngeal defects, must be considered in selected cases.