Vascular pedicle flap of the thyroid or submandibular gland in the reconstruction following partial laryngectomy

Abstract The paper presents the merits and drawbacks of vascular pedicled flaps of thyroid and submandibular glands in the reconstructive surgery following partial laryngectomy (combined with the resection of tongue base if necessary), as well as the results of clinical, radiological, radionucleoloid++ and histological investigation carried out in 81 cases with various extend of neoplasm (T1-T4). The average observation period was 8.2 (min. 1, max. 14) years. The discussed flaps were satisfactorily elastic and rigid, allowed formation in monobloc even complex structures (for instance vocal cord, arytenoid eminence, lateral wall of the larynx) with the high healing rate (1 total and 2 partial losses only), with an insignificant degree of atrophy in the larynx and a considerably greater one in the tongue base (despite a very difficient cover with mucosa), as well as a small local recidive range (3/81 cases all coming from the tissue out of the flap). With the above data, the discussed flaps seem to be superior in many respects to the materials conventionally used in the reconstruction of the larynx. A subclinical form of hypothyreosis (reduced level of T3, T4 and TSH) was stated in 1 case only, whereas xerostomy was not observed in any. The detailed oncological and functional results obtained in the whole group of patients will be published in another paper.