gms | German Medical Science

77. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

24.05. - 28.05.2006, Mannheim

Reconstruction of the hypopharynx and cervical esophagus according to the method of Spriano, Piantanida and Pellini

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Jobst von Scheel - HNO-Abt., Asklepios-Klinik St. Georg, Hamburg, Germany
  • Wolfgang Teichmann - 1. Chirurgische Abt., Asklepios-Klinik Altona, Hamburg, Germany

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno087

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Veröffentlicht: 7. September 2006

© 2006 von Scheel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: The most commonly used techniques for reconstruction of the upper digestive tract after laryngopharyngectomy are gastric pull-up or microvascular surgery using jejunum or free skin flaps. The pectoralis major myocutaneous flap has proven to be helpful only after limited resection. However, Fabian [1] introduced the myocutaneous flap for reconstruction of the anterior and the lateral walls of the hypopharynx, while the prevertebral fascia was covered by a free skin graft. Spriano et al. modified the method by leaving the prevertebral fascia uncovered [2]. It was the aim of our study to evaluate the proposal of Spriano et al..

Methods: The hypopharyngeal tumors of 4 male patients (42-57 years old) were resected by laryngopharyngectomy, including upper parts of the esophagus. The reconstruction was performed according to the proposal of Spriano et al., leaving the prevertebral fascia uncovered.

Results: All patients recovered quickly. The gastric tube was removed after 10-18 days. In one case a salivary fistula and stenosis developed requiring longterm but temporary stenting. One patient suffered a recurrence. Two patients had good swallowing capability, immediately and sustainably (up to more than 2.5 years).

Conclusions: The method of Spriano et al. can be recommended for reconstruction after laryngopharyngectomy. The advantages as compared to gastric pull-up or free tissue transfer are a shorter operating time, a lower complication rate und good functional results. However, if the tumor requires resection of more than 3-5 cm of intrathoracic parts of the esophagus, gastric pull-up should be preferred.


References

1.
Fabian R. Reconstruction of the laryngopharynx and cervical esophagus. Laryngoscope 138 (1984) 1334-1350
2.
Spriano G, Piantanida R, Pellini R. Hypopharyngeal reconstruction using pectoralis major myocutaneous flap and pre-vertebral fascia. Laryngoscope 111 (2001) 544 - 547