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Two Cases of Radial Forearm Free Flap Reconstruction after Wide Vertical Hemipahryngolaryngectomy  

Moon Il-Joon (Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
Hong Sung-Lyung (Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
Kim Si-Whan (Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
Ahn Soon-Hyun (Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
Publication Information
Korean Journal of Head & Neck Oncology / v.21, no.1, 2005 , pp. 35-41 More about this Journal
Abstract
Wide vertical hemilaryngopharyngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap is reported in 1991 by Chantrain et al. This procedure was designed for the preservation of healthy hemilarynx and resection of pharynx with safe oncological margin in especially piriform sinus cancer or supraglottic cancer invading the hypopharynx. In the original paper, they used palmaris longus tendon for reconstruction of neoglottis. In other groups, they used rib cartilage instead of palmaris longus tendon. In this paper, we report two cases of piriform sinus cancer patients who treated with wide vertical hemilaryngectomy with radial forearm free flap reconstruction. In one case, the operation was performed as Chantrain et al described. But in another case, the ipsilateral forearm was impossible due to the positive Allen's test. So the contralateral forearm flap and rib cartilage graft was done. This reconstructive technique make large resection possible. As the dissection of thyroid cartilage and lateral displacement makes direct visualization and manipulation of piriform sinus lesions, sufficient resection margin in lateral and inferior pharyngeal wall cab be obtained.
Keywords
Hypopharyngeal neoplasm; Laryngeal neoplasm; Surgical flap;
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