Clinical application of modified bilobed chimeric thoracoacromial artery perforator flap for reconstruction of hypopharyngeal defect with anterior neck skin loss / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

Objective@#To evaluate the efficacy of modified bilobed chimeric thoracoacromial artery perforator (TAAP) flap for the reconstruction of hypopharyngeal defect with anterior neck skin loss.@*Methods@#Between May 2013 and September 2015, modified bilobed chimeric TAAP flap was used to reconstruct complex oncologic hypopharyngeal defects in 7 patients, including 6 males and 1 female. Patients′ age ranged from 28 to 65 years old (mean age 50±3.4 years old). The size of hypopharyngeal defect ranged from 5.5 cm×3.5 cm to 12.0 cm×4.5 cm, and the size of anterior neck defect ranged from 8.0 cm×4.0 cm to 10.0 cm×4.0 cm.@*Results@#The size of TAAP flap was from 6.5 cm×4.0 cm to 13.0 cm×5.0 cm.The size of pectoralis major flap was from 8.0 cm×4.5 cm to 11.0 cm×5.0 cm. The length of pedicle was 6.5-8.5 cm.The distance from pivot point of flap to central point of recipient site was 7.0-9.5 cm.All flaps survived thoroughly, the donor site was closed directly in all cases.The mean hospital stay ranged from 14 to 19 days (mean 15.5 days). The follow-up was 14, 15, 20, 18, 30, 25 and 38 months respectively.Patient possessed good appearance of neck surgical sites, and oral diet was restored in all patients.No recurrence, fistula, stenosis/stricture, dehiscence, or swelling occurred, only with scars left on the donor sites, and pectoralis major muscle function was completely preserved in all patients.@*Conclusions@#Modified bilobed chimeric TAAP flap is a good choice for the reconstruction of hypopharyngeal defect with anterior neck skin loss.