Efficacy and Safety of Microsurgical Pharyngolaryngeal and Pharyngoesophageal Reconstruction: A Systematic Review of the Literature

Overview

Journal Plast Reconstr Surg Glob Open

Specialty General Surgery

Date 2023 May 1

PMID 37124383

Authors

Konstantinos Gasteratos

Nikolaos Vlachopoulos

George Kokosis

Jeremy Goverman

Affiliations

Soon will be listed here.

Abstract

Methods: We performed a systematic literature review on PubMed (Medline), Embase and Cochrane Library over the last two decades for articles reporting the surgical reconstructive modalities available after total or partial pharyngeal and/or laryngeal resection using a structured search strategy and strict inclusion and elimination criteria.

Results: Our search identified a total of 677 articles, 112 full texts were fully reviewed for eligibility, and 39 met the inclusion criteria. The use of both FJF and fasciocutaneous flaps is safe. The FJF has optimal swallowing outcomes and a low incidence of major recipient-site complications. Nevertheless, free fasciocutaneous flaps exhibit comparable functional results, while they seem linked with fewer cases of perioperative mortality and flap failure. However, none of the currently available techniques can combine all potential benefits.

Conclusions: Despite these procedures being mainly palliative in nature, the advent of microvascular techniques and utilization of fasciocutaneous free flaps has allowed optimal restoration of function combined with a reduced rate of perioperative and longterm complications. Both FJF and fasciocutaneous flaps can be viable treatment options, depending on the expertise of the surgeon and patient selection, to ensure the best outcomes.

Citing Articles

Reconstruction for Salvage Laryngectomy With Limited Pharyngectomy.

Moreno M, Wax M, Gardner J, Cannady S, Graboyes E, Bewley A JAMA Otolaryngol Head Neck Surg. 2024; 150(6):492-499.

PMID: 38635282 PMC: 11177165. DOI: 10.1001/jamaoto.2024.0103.

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