Infrahyoid muscle flap as augmentation of pharyngeal repair after total laryngectomy

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-04-12 DOI:10.1111/coa.14166

Ahmed Hassan Sweed, Alsayed Abdulmageed, Ahmed Abdelfattah Bayomy Nofal, Mohammed Elsayed Elmaghawry, Mohamed Abdelmohsen Alnemr

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Abstract

Introduction

To assess the usage of contralateral infrahyoid muscles as onlay flap in prevention of pharyngo-cutaneous fistula (PCF) in total laryngectomy (TL) patients with high risk factors of PCF development.

Methods

This study included 10 patients who suffered from advanced laryngeal carcinoma with presence of risk factors for development of PCF. We added an enforcement muscular layer during neo-pharynx wall repair, the infrahyoid muscle flap of the contralateral side of the tumour origin as an onlay muscular flap to cover the anastomotic site for healing augmentation. Patients were followed up for PCF development where the PCF incidence was calculated.

Results

One patient died from congestive heart failure in the 21th post-operative day so, the actual PCF rate in TL patients with high risk factors of PCF development in our study was 11.11% (1 out of 9 cases).

Conclusions

Infrahyoid muscle flap may have a role in preventing PCF after TL in patients with high risk factors of PCF development in this case series study to be further assessed in other studies to justify its role.

Level of evidence: 4.

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咽下肌皮瓣作为全喉切除术后咽部修复的辅助手段

方法本研究纳入了10例存在PCF发病风险因素的晚期喉癌患者。我们在新咽壁修复过程中增加了一个执行肌肉层，即肿瘤来源对侧的hyraoid下肌皮瓣，作为覆盖吻合口部位的嵌合肌肉瓣，以增强愈合。结果一名患者在术后第 21 天死于充血性心力衰竭，因此，在我们的研究中，具有 PCF 发生高危因素的 TL 患者的 PCF 实际发生率为 11.11%（9 例中有 1 例）。结论在本病例系列研究中，膈下肌皮瓣可能在预防具有 PCF 发生高危因素的 TL 患者术后 PCF 方面发挥作用，有待其他研究进一步评估以证明其作用：4.

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.