MICROVASCULAR FREE TISSUE RECONSTRUCTION AFTER TOTAL LARYNGECTOMY

Twelve latissimus dorsi flaps, five radial fore-arm flaps, one scapular flap, two combined latissimus dorsi and scapular flaps, six jejunal and seven gastroomental flaps were used to reconstruct defects following surgical treatment of laryngeal and hypopharyngeal cancer in 33 patients. Reconstruction provided a mucosal lining in 7 patients, external coverage in 11 patients, and both a mucosal lining and external coverage in 15 patients. There were two flap failures in this series. The average operating time was eight hours. There was a single postoperative death due to pneumonia. Local wound complication was noted in nine patients. Twenty-eight patients had adequate swallowing after operation. The lower morbidity and mortality in these patients with very advanced disease make these methods acceptable means for restoration of the function of the alimentary tract in the neck.