Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients

Wahib Ghanem; Quentin Qassemyar; Morbize Julieron; Frédéric Kolb; Nicolas Leymarie; Antoine Moya-Plana; François Janot; Stéphane Temam; Nadia Benmoussa

doi:10.1002/hed.27474

Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients

Wahib Ghanem, Quentin Qassemyar, Morbize Julieron, Frédéric Kolb, Nicolas Leymarie, Antoine Moya-Plana, François Janot, Stéphane Temam, Nadia Benmoussa

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. Materials and Methods: Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. Results: There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1–14] months after surgery. Conclusion: SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.

Original language	English
Pages (from-to)	2335-2343
Number of pages	9
Journal	Head and Neck
Volume	45
Issue number	9
DOIs	https://doi.org/10.1002/hed.27474
Publication status	Published - 1 Sept 2023

Keywords

free flap
pharyngolaryngectomy
reconstruction
urken technique

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10.1002/hed.27474

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title = "Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients",

abstract = "Introduction: Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. Materials and Methods: Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. Results: There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1–14] months after surgery. Conclusion: SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.",

keywords = "free flap, pharyngolaryngectomy, reconstruction, urken technique",

author = "Wahib Ghanem and Quentin Qassemyar and Morbize Julieron and Fr{\'e}d{\'e}ric Kolb and Nicolas Leymarie and Antoine Moya-Plana and Fran{\c c}ois Janot and St{\'e}phane Temam and Nadia Benmoussa",

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year = "2023",

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doi = "10.1002/hed.27474",

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T2 - A case series of 17 patients

AU - Ghanem, Wahib

AU - Qassemyar, Quentin

AU - Julieron, Morbize

AU - Kolb, Frédéric

AU - Leymarie, Nicolas

AU - Moya-Plana, Antoine

AU - Janot, François

AU - Temam, Stéphane

AU - Benmoussa, Nadia

PY - 2023/9/1

Y1 - 2023/9/1

N2 - Introduction: Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. Materials and Methods: Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. Results: There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1–14] months after surgery. Conclusion: SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.

AB - Introduction: Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. Materials and Methods: Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. Results: There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1–14] months after surgery. Conclusion: SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.

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KW - urken technique

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Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients

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