Abstract
Salvage total laryngectomy following radiation therapy or chemoradiotherapy is known to be associated with a high rate of pharyngocutaneous fistula(PCF) due to the impaired healing capacity of the tissue bed. Numerous techniques have been introduced to minimise wound healing complications and PCF in salvage laryngectomy patients, the most common being a pedicled pectoralis major myofascial/myocutaneous flap as an onlay to bolster the pharyngotomy repair or a fasciocutaneous free flaps (eg: ALT, radial forearm) which is interposed between the pharyngeal mucosa.1,2 With the improved reliability of free flap surgery, we are reporting on an alternative method of bolstering the pharyngeal repair with an adipofascial radial forearm free flap to act as a bolster overlying the pharyngotomy closure to improve tissue vascularity and reinforce the pharyngeal suture line in this group of previously irradiated patients.
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