Reconstruction after Salvage Laryngectomy

Abstract

Program Description: Patients undergoing salvage laryngectomy after concurrent chemoradiation are predisposed to impaired wound healing that can lead to pharyngocutaneous fistula (PCF). When a PCF develops, extended hospitalization and/or re-operation are often required. A variety of reconstructive techniques are used to try and mitigate this complication and improve outcome. The microvascular committee conducted a multicenter retrospective review at 19 institutions. Data on over 450 patients will be presented. Overall, pharyngocutaneous fistula rates were 36% and ranged from 21-46% based on reconstructive approach and size of accompanying pharyngeal defect. Differences in reconstructive approach and guidelines for treating this patient group will be presented. Educational Objectives: 1) Demonstrate the research approach to a multi-institutional review to establish treatment guidelines for the reconstruction of salvage laryngectomy patients. 2) Contrast reconstructive approaches for the patient undergoing salvage laryngectomy. 3) Provide practice-based evidence for the reconstruction of the salvage laryngectomy patient.