Repair of salivary fistula after reconstruction of pharyngoesophagus.

We describe three surgical methods used to repair salivary fistulas in different situations that are seen after reconstruction of the pharyngoesophagus in patients with hypopharyngeal cancer. The principle of these methods is the same; a cervical skin flap next to the fistula is used as the internal lining and an anterior chest skin flap is rotated as an external lining to cover it. For the primary closure of heavily irradiated fistulas, this combination may not always be effective, and we emphasize that a combined use of a pedicled pectoralis major muscle flap with these two kinds of pedicled skin flap is extremely reliable.