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

OBJECTIVES

The purpose of this study was to evaluate the application of the supraclavicular artery island flap (SCAIF) for the reconstruction of laryngopharyngectomy defects in comparison with reconstructions with the anterolateral thigh flap (ALT) and the radial forearm flap (RFF).

PATIENTS AND

METHODS

A retrospective study was performed. We compared indications for surgery, reconstructive techniques, operative time, time of hospitalization, and complication rates between patients treated with SCAIF, RFF and ALT following laryngopharyngectomy. Seventy-seven patients were included, 18 underwent reconstruction with SCAIF (23%), 36 with RFF (47%), and 22 with ALT (29%). Seventy-five laryngopharyngectomies (97%) were performed due to oncologic indications, 27 patients (35%) had been treated with prior radiotherapy. Fifty-seven defects (74%) were partial defects, whereas 20 (26%) were circumferential.

RESULTS

No statistical differences in operative time between the groups (298 min ± 53 [SCAIF] vs 301 min ± 54 [ALT] vs 302 min ± 47 [RFF]; P = .806) were observed. Preoperative radiation was found to be an independent risk factor for flap loss (P < .001), the development of fistula (P = .032), and pharyngeal stenosis (P = .034) in our cohort. Nevertheless, no differences between the different groups were detected (fistula rate: 11% [SCAIF] vs 14% [ALT] vs 11% [RFF]; P = .944, stenosis rate: 11% [SCAIF] vs 14% [ALT] vs16% [RFF]; P = .874, gastric tube dependency: 28% [SCAIF] vs 23% [ALT] vs16% [RFF]; P = .590).

CONCLUSION

The SCAIF is an equivalent alternative compared to well-established techniques, such as the RFF and the ALT regarding reconstruction of defects after laryngopharyngectomy.