Advantages and limitations of free and pedicled flaps in reconstruction of pharyngoesophageal defects.

Abstract

The current review will focus on head and neck reconstructive techniques for the pharyngoesophagus. This article reviews the changing patterns of flap usage and will evaluate the advantages and disadvantages of selected pedicled and free flaps for pharyngoesophageal reconstruction. A number of flaps are reviewed with particular emphasis on recent developments. The literature reports on a variety of options available to reconstruct pharyngoesophageal defects. Pedicled flaps have a role in partial defects and select short to moderate circumferential length defects. The standard for long segment circumferential defects continues to be the fasciocutaneous free flaps and the jejunum free flap. The exact nature of the pharyngoesophageal defect, patient characteristics, and flap availability should be considered when choosing the best option for reconstruction.