Preliminary Study on Phonation Reconstruction Using Free Anterolateral Thigh and Sternohyoid Myocutaneous Flaps After Total Laryngectomy.

OBJECTIVE

In this study, we evaluated and compared the outcomes of phonation reconstruction using free anterolateral thigh (ALT) and sternohyoid myocutaneous flaps in patients undergoing total laryngectomy for locally advanced laryngeal and hypopharyngeal cancers, providing insights into optimal reconstructive approaches.

MATERIALS AND

METHODS

A total of 10 patients with locally advanced laryngeal or hypopharyngeal at Liaoning Cancer Hospital & Institute were enrolled. All patients underwent total laryngectomy with simultaneous voice reconstruction. The reconstruction method was selected based on the extent of the hypopharyngeal defect. For patients without mucosal defects in the hypopharynx (n = 7), a sternohyoid myocutaneous flap was used. For those with large mucosal defects (n = 3), a free ALT flap was applied for voice reconstruction. Quality of life (QoL) was assessed preoperatively and postoperatively using a modified Chinese version of the University of Washington Quality of Life (UW-QOL) questionnaire. Postoperative complications were analyzed.

RESULTS

Both ALT and sternohyoid myocutaneous flaps demonstrated good feasibility and safety in phonation reconstruction following total laryngectomy. Phonation was achieved intraoperatively without the need for additional voice prosthetic devices. No statistically significant differences were observed between the groups regarding QoL or postoperative complications.

CONCLUSION

Preliminary findings suggest that both ALT and sternohyoid myocutaneous flaps are viable options for phonation reconstruction following total laryngectomy. Phonation reconstruction contributed to a moderate improvement in patients' quality of life post-laryngectomy. Strengthening perioperative management is essential for optimizing surgical outcomes. Further studies with larger sample sizes and controlled designs are warranted to validate these findings and provide more robust evidence to guide the selection of surgical techniques in clinical practice.