Repair of complex pharyngocutaneous fistula using a staged temporoparietal fascial flap

Nicholas B. Abt, Priya Srikanth, Sidharth V. Puram, Daniel G. Deschler

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Introduction PCF is the most common major complication after salvage total laryngectomy (TL), especially for previously irradiated patients with laryngeal or hypopharyngeal cancer. Methods/results A 65-year-old woman presented with recurrent bilateral supraglottic SCC requiring salvage TL 5.5 years after initial T1N0M0 epiglottic SCC resection. Her post-operative course was complicated by PCF development one month post-operatively and surgical fistula closure was delayed for adjuvant chemoradiotherapy. The fistula persisted despite local wound therapy, several primary closures, pectoralis flap reconstruction with multiple revisions, and extensive hyperbaric oxygen treatments. Given her prior history, she underwent a staged right temporoparietal fascial flap reconstruction for persistent complex fistula, with second-stage flap takedown and complete inset of the TPFF skin island into the PCF. Conclusion This case demonstrates the utility of staged TPFF in complex PCF repair, with minimal morbidity, especially in a patient with prior irradiation and flap use that complicates tissue availability.

Original languageEnglish
Pages (from-to)254-256
Number of pages3
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume38
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

  • Fistula
  • Flap
  • Pharyngocutaneous fistula
  • TPFF
  • Temporoparietal fascial flap

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