Correction of cervical esophageal stricture using an axial island cheek flap

Chronic strictures of the cervical esophagus after laryngectomy and radiation therapy pose a difficult problem in reconstructive surgery. Most conventional operations for cervical esophageal reconstruction are not well suited to the treatment of stricture because of lack of mucosal surface, or because of bulky tissues that awkwardly fit around the tracheal stoma. This report describes our experience with a new operation designed to correct this defect. We transposed an island full-thickness cheek flap, which included an inner lining of mucosa and outer covering of skin. The flap was based on the facial artery and vein, and used as a patch to the stricture area. Normal swallowing and excellent cosmetic appearance were achieved. There has been minor numbness of the corner of the upper lip. This flap has excellent reach, and may have multiple applications to reconstruction problems in the head and neck.