Reconstruction of laryngopharyngectomy defects: Comparison between the supraclavicular artery island flap, the radial forearm flap, and the anterolateral thigh flap

Microsurgery ◽  
2018 ◽  
Vol 39 (4) ◽  
pp. 310-315 ◽  
Author(s):  
Maximilian Reiter ◽  
Philipp Baumeister
Keyword(s):  
Island Flap ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Radial Forearm ◽  
Supraclavicular Artery Island Flap

Hypopharyngeal, Esophageal, and Neck Reconstruction

2018 ◽  
Author(s):  
Steven B Chinn ◽  
Peirong Yu
Keyword(s):  
Perforator Flap ◽  
Ulnar Artery ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Pharyngoesophageal Reconstruction ◽  
Radial Forearm ◽  
Artery Perforator

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations. This review contains 23 figures, 3 tables and 39 references Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap

Oral Cancer Reconstruction Using the Supraclavicular Artery Island Flap: Comparison to Free Radial Forearm Flap

2017 ◽  
Vol 75 (10) ◽  
pp. 2261-2269 ◽  
Author(s):  
Christian Welz ◽  
Martin Canis ◽  
Sabina Schwenk-Zieger ◽  
Jennifer L. Spiegel ◽  
Bernhard G. Weiss ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Island Flap ◽  
Radial Forearm Flap ◽  
Forearm Flap ◽  
Free Radial Forearm Flap ◽  
Radial Forearm ◽  
Supraclavicular Artery Island Flap ◽  
Oral Cancer Reconstruction

scholarly journals Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
N. Lumen ◽  
S. Monstrey ◽  
P. Ceulemans ◽  
E. van Laecke ◽  
P. Hoebeke
Keyword(s):  
Free Flaps ◽  
Functional Results ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Free Radial Forearm Flap ◽  
Anterolateral Thigh ◽  
Aesthetic Results ◽  
Radial Forearm

Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy.Methods. Eleven males (age 15 to 42 years) were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months). Aesthetic and functional results were evaluated.Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula). Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion.Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

Hypopharyngeal, Esophageal, and Neck Reconstruction

2018 ◽  
Author(s):  
Steven B Chinn
Keyword(s):  
Perforator Flap ◽  
Ulnar Artery ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Anterolateral Thigh ◽  
Pharyngoesophageal Reconstruction ◽  
Radial Forearm ◽  
Artery Perforator

Organ preservation protocols with radiotherapy have become the primary treatment for stage I to III laryngeal and hypopharyngeal carcinoma. Many pharyngoesophageal defects are the result of salvage laryngopharyngectomy following radiation failure, making reconstruction more challenging. Given the detrimental effects of radiation on wound healing, reconstruction bathed in saliva, and the frozen neck with poor recipient vessels, pharyngoesophageal reconstruction requires great attention to detail to avoid catastrophic complications. In this review, we detail the commonly used flaps for pharyngoesophageal reconstruction, including the radial forearm flap, anterolateral thigh flap, and jejunal flap. In recent years, the anterolateral thigh flap has become the optimal flap for this type of reconstruction due to its minimal donor-site morbidity and excellent functional outcomes. Use of a two-skin island anterolateral flap allows for pharyngoesophageal reconstruction with simultaneous neck resurfacing. The profundus artery perforator flap can be a good alternative to the anterolateral thigh flap, whereas the ulnar artery perforator flap may be a good alternative to the radial forearm flap in certain cases. We discuss recipient vessel selection and conclude by outlining important postoperative considerations. This review contains 23 figures, 3 tables and 39 references Key words: anterolateral thigh flap, anteromedial thigh flap, frozen neck, gastro-omental flap, hypopharynx, laryngeal cancer, perforator flaps, pharyngocutaneous fistula, pharyngoesophageal reconstruction, profundus artery perforator flap, radial forearm flap, tracheoesophageal puncture, transverse cervical vessels, ulnar artery perforator flap

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