• 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. • This study was a retrospective review of patients undergoing SFTT for head and neck defects between 2009 and 2014 at a tertiary center. The cohort included patients undergoing reconstruction of PE defects with at least 6 months follow up. Seventeen patients (13 male and 4 female) met inclusion criteria. Surgical outcomes, speech, voice outcomes, swallowing outcomes, enteral feeding and tracheoesophageal puncture (TEP) usage were evaluated. • 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. • The SFTT is a viable option for hypopharyngeal reconstruction. All scapula free tissue transfers remained viable for the duration of our review. Post-operative PCF rate were comparable to that reported after laryngectomy.

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.