The Supraclavicular Artery Island Flap for Pharynx Reconstruction.

The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or "U"-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction.

Sudden Sensorineural Hearing Loss Following the Second Dose of COVID-19 Vaccine.

Sudden sensorineural hearing loss (SSHL) is a common otolaryngology emergency that significantly affects the patient's quality of life. Although in most cases its etiology remains unknown (idiopathic SSHL), viral infections and vascular compromise constitute the most widely accepted etiopathogenic mechanisms. Specifically, occlusion of the internal auditory artery has been reported in cases of sudden deafness. Thrombotic events following the Oxford-AstraZeneca COVID-19 vaccine are rare. There have been reports of SSHL following immunization with Pfizer and Moderna COVID-19 vaccine; however, no etiologic relationship has been established between the two entities yet. We present a unique case of SSHL following the second dose of the Oxford-AstraZeneca COVID-19 vaccine. A 61-year-old female was referred to our department with a four-day history of the right-sided sense of fulness combined with almost complete hearing loss that had started two days after the second dose of Oxford-AstraZeneca COVID-19 vaccine. Pure tone audiometry showed profound right-sided sensorineural hearing loss. Magnetic resonance imaging of the brain and internal auditory canal and magnetic resonance angiography were both normal. The combination of glucocorticoids and acetylsalicylic acid leads to almost full recovery 15 days after deafness. The COVID-19 era is full of new challenges and clinical dilemmas. In our case, the addition of acetylosalicid acid to the patient's initial treatment may have contributed to the hearing restoration; however, this fact will remain a hypothesis.