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Repair of post-laryngectomy pharyngeal fistulae

Published online by Cambridge University Press:  29 June 2007

J. S. Rubin
J. S. Rubin*
Affiliation:
Department of Otorhinolarynolaryngology, Montefiore Medical Center, van Cortlandt Annex, Room 710, 111 East 210th Street, Bronx, New York 10467
*
John S. Rubin, M.D., 48 Sagamore Road, Apt. 20, Bronxville N. Y. 10708.
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Abstract

Post-laryngectomy pharyngeal fistulization is an unpleasant occurrence. Presented herein is the author's approach to this problem, along with two cases in which closure was effected by sternocleidomastoid (SCM) myoplasty.

SCM myocutaneous flaps have previously been considered for pharyngocutaneous fistulae and then disregarded due to the doubtful nature of the blood supply to the skin. The SCM myoplasty obviates this problem as it relies on muscle rather than skin. SCM myoplasty has been used as a bolster in pharyngeal reconstruction after the pharynx has been closed by pharyngeal mucosal advancement or rotation. The author has extended this idea utilizing the raw muscle of the SCM to directly reconstruct the defect in fistulae deemed too large for primary closure.

Anatomical, oncological and technical considerations are discussed, as well as the author's protocol for post-laryngectomy pharyngocutaneous fistulae.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 3 , March 1989 , pp. 302 - 305
Copyright
Copyright © JLO (1984) Limited 1989

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