Abstract
Objective:Scapular and parascapular free tissue transfer (SFTT) is a
well described reconstructive option for the head and neck. Majority of
reported outcomes are of reconstruction of oromandibular and midface
defects. The aim was to describe one institution’s experience with SFTT
for reconstruction of PE defects. Design: Retrospective review of
patients undergoing SFTT for head and neck defects between 2009 and 2014
at a tertiary medical center. The cohort included patients undergoing
reconstruction of PE defects with at least 6 months follow up.
Setting:Tertiary medical center Participants:Patients undergoing SFTT
for PE defects. Seventeen patients (13 male and 4 female) met inclusion
criteria. Main outcomes and Measures: Surgical outcomes, speech, voice
outcomes, swallowing outcomes, enteral feeding and tracheoesophageal
puncture usage. Results:Seventeen patients met criteria – 4 female,
average age at time of surgery 64.5 (SD 9.1). Thirteen patients were
Caucasian and remaining four African American. Two of 17 patients
developed pharyngocutaneous fistulas (PCF) as inpatients. There was one
major medical complication (pulmonary embolism) and 7 minor
complications. Mean hospital length of stay was 15.7 days (SD 8.2). In
post-operative setting, only one patient remained PEG-dependent, 11
patients supplemented oral intake with PEG feeds and 5 patients took
nutrition solely by mouth. Four patients utilized written communication
exclusively, 6 patients pursued TEP placement and 7 utilized
electrolarynx. Conclusion:The SFTT is a viable option for hypopharyngeal
reconstruction. All SFTT remained viable for the duration of our review.
Post-operative PCF rate were comparable to that reported after
laryngectomy.