Effects of Radiotherapy on Pharyngeal Reconstruction After Pharyngo-Laryngectomy

After adequate extirpation of tumours in the hypopharynx, the defect created should be reconstructed appropriately to provide optimal function. Local cervical skin flaps were first described and employed 60 years ago for the reconstruction of defects after pharyngolaryngectomy 1. However, the procedures involved had to be carried out in stages, which typically required 4 – 6 months for completion. In addition, the subsequent ability to swallow was frequently limited by the stenosis at the anastomotic junction. Nowadays, with more advanced techniques, reconstruction of the circumferential hypopharyngeal defect is nearly always performed at the time of resection as a single stage procedure 2. The most commonly employed reconstructive options include the use of myocutaneous flaps (pedicled pectoralis major flap or free anterolateral thigh flap) with the skin island sutured and fashioned as a tubular conduit, or the free visceral flap (free jejunal flap).