Reconstruction of the larynx with unipedicled sternohyoid myofascial flap following open extended vertical partial laryngectomy

Abstract

<p class="abstract">The extent of resection during open vertical partial laryngectomy may vary considerably and even an experienced surgeon may encounter difficulties in reconstructing the larynx to preserve laryngeal function and to prevent stenosis. Different local flaps were proposed for reconstruction; however, the ideal technique is still under development. A simple modification to the technique originally described by Calcaterra (1983) is presented. The unipedicled sternohyoid myofascial flap consists of the unsplit sternohyoid muscle with all three overlying fasciae harvested as a whole. The flap is rotated 90° and horizontally sutured in position to supply the necessary bulk to the entire neocord to produce a functional voice. Completely filling the mucosal defect USMF-flap allows laryngeal structures to maintain their native position and retain protective function of the larynx. The thick multilayered fascia covering facilitates rapid epithelization and prevents excessive granulation and secondary stenosis. The technique is indicated in glottic cancer patients treated by open extended vertical partial laryngectomy when the laryngeal mucosa defect is too extensive for primary closure and poses significant risk of developing postoperative stenosis.</p>