• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.198-204
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• 2001

Background and Objectives: As the laryngopharyngeal cancer is usually found at a advanced stage, it is difficult to get a wide surgical margin that preserves functional aspect and that is oncologically safe simultaneously. There were many operative technique to fulfill this principle, but none were satisfactory. Recently there were some reports about glottic and pharyngeal reconstruction using radial forearm free flap(RFFF) with palmaris longus tendon, which provided satisfactory oncologic and functional results. We attempted to perform this technique and to test usefulness at patients of laterally localized laryngopharyngeal tumor. Materials and Methods: Three patients were reconstructed glottis and pharynx using radial forearm free flap with palmaris longus tendon. Two hypopharyngeal cancer (T2N0M0) patients were performed wide vertical hemilaryngopharyngectomy and one supraglottic cancer(T2N0M0) patient was performed horizontovertical laryngopharyngectomy. Deglutitional function was evaluated with modified barium swallow and speech function was evaluated by speech pathologist. Results: Mean follow-up time was 29.3 months. There were no cancer recurrence. Their speech was satisfy-actory at social communication and oral feeding. They all have a complete oral nutrition from 26 days to 53 days. Decanulation time was from 71 days to 30 months. Conclusion: Glottic and pharyngeal reconstruction with radial forearm free flap could be accepted as a promising technique which offers a wide resection margin but satisfactory functional result in lateralized laryngohypopharyngeal cancer patients.

• Korean Journal of Head & Neck Oncology
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• v.21 no.1
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• pp.35-41
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• 2005

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.