Comparative Study of Free Flap Reconstruction after Total Laryngopharyngectomy for Hypopharyngeal Cancer

Abstract

Received May 13, 2013 Revised July 18, 2013 Accepted July 18, 2013 Address for correspondence Kyung Tae, MD Department of OtolaryngologyHead and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Korea Tel +82-2-2290-8585 Fax +82-2-2293-3335 E-mail kytae@hanyang.ac.kr Background and ObjectivesZZRecently, both jejunal and fasciocutaneous free flap reconstruction are widely used after total laryngopharyngetomy for the treatment of hypopharyngeal cancer. The aim of this study is to evaluate and compare the functional outcomes between jejunal and fasciocutaneous free flap in the reconstruction of hypopharynx after total laryngopharyngectomy. Subjects and MethodZZThe medical records of 27 patients with hypopharyngeal cancer who underwent total laryngopharyngectomy and free flap reconstruction were reviewed retrospectively. Of 27 patients, 18 (66.7%) were reconstructed with jejunal free flap and 9 (33.3%) with fasciocutaneous free flap. We compared complications, flap success rates, functional outcomes such as swallowing, respiration and quality of life (QOL) between two reconstruction groups. The swallowing function was evaluated by Functional Outcome of Swallowing Scale (FOSS), and QOL was evaluated by EORTC QOL-C30, HN35. ResultsZZTwenty-seven patients consisted of 26 males and 1 female. The mean age of 69±9.1. There were 4, 13, and 10 cases for T2, T3, and T4, respectively. Also, there were 8, 5, 7, and 7 for N0, N1, N2 and N3 cases. The success rate of free flap was 96.3%. The complication rate, operative time, the period of hospital stay did not differ between the two groups. The average score of FOSS was 0.92 in the jejunal group and 1.00 in the fasciocutaneous group. Quality of life was satisfactory in both groups. ConclusionZZBoth jejunal and fasciocutaneous free flap are very effective reconstructive methods after total laryngopharyngectomy for hypopharyngeal cancer. The choice of free flap can be determined based on the individual status of patient and preference of surgeon. Korean J Otorhinolaryngol-Head Neck Surg 2013;56:569-73