HYPOPHARYNGEAL RECONSTRUCTION WITH FREE ANTEROLATERAL THIGH FLAP --- - - PowerPoint PPT Presentation

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Aug 22, 2022 181 likes •336 views

HYPOPHARYNGEAL RECONSTRUCTION WITH FREE ANTEROLATERAL THIGH FLAP --- PARALLEROGRAM DESIGN 1 Yi-Shin Lu, 1 Yu-Hsien Lin, 1 Hwang-Chi Lin, 2 Sheng-Po Hao 1 Division of Plastic Surgery, Department of Surgery; 2 Department of Otolaryngology Head and

SLIDE 1

HYPOPHARYNGEAL RECONSTRUCTION WITH FREE ANTEROLATERAL THIGH FLAP

-- PARALLEROGRAM DESIGN

1Yi-Shin Lu, 1Yu-Hsien Lin, 1Hwang-Chi Lin, 2Sheng-Po Hao 1Division of Plastic Surgery, Department of Surgery; 2Department of Otolaryngology Head and Neck Surgery;

Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

SLIDE 2

The authors have no commercial associations

r financial disclosures that might pose
r create a conflict of interest with the

information presented in this article. No funding was received for this work.

SLIDE 3

Objective of the study

฀1. hypopharynygeal cancer was preferred

to be performed surgical intervention

฀2. Our novel design of

tubed parallelogram free ALT flap

฀3. Chimeric flap was designed for flap

monitoring

฀4. results of our patients

SLIDE 4

Materials – Case

฀65 y/o male

฀ dysphagia and easily choking ฀ for about 1 month

฀Diagnosis:

Hypopharyngeal cancer cT4aN1M0, stage IVA SCC

SLIDE 5

the defect after total pharyngectomy

7 cm 10 cm

SLIDE 6

Methods

฀1. our design:

parallelogram free ALT flap

฀2. tubing with using 50c.c. synringe ฀3. chimeric design:

฀ muscle+ fasciocutaneous ฀ fasciocutaneous+ fasciocutaneous

Reconstruction after pharyngectomy

SLIDE 7

Our design: parallelogram free ALT flap

parallelogram free ALT flap

10 cm 7 cm <8 cm

SLIDE 8

Tubing Tubing with using 50c.c. synringe

diameter of 3 cm

2πr≈10 cm

SLIDE 9

Flap monitoring:

chimeric design

SLIDE 10

Results: the donor site

primary closure

SLIDE 11

Results clinical course

Day1 Day14

try water

Day16

removed NG

Day21

liquid diet

Day17 Day25 Day2

soft diet discharged admissio n OP

SLIDE 12

Esophagography (2/17): no leakage

SLIDE 13

฀1. parallelogram design of free ALT flap is

alternative choice for reconstruction after pharyngectomy

฀2. similar functional results

as tranditional design

฀3. primary closure for donor site

Conclusions:

SLIDE 14

In our hospital, F/u till Apr,2014

฀Hypopharyngeal cancer

s/p wide excision + reconstruction ฀ From 2010/4 to 2014/2 ฀ Total of 13 patients: ฀ Soft diet: n=7 (54%) ฀ Liquid diet: n=3 (23%) ฀ Nil: n=3 (23%)

SLIDE 15

HYPOPHARYNGEAL RECONSTRUCTION WITH FREE ANTEROLATERAL THIGH FLAP

1Yi-Shin Lu, 1Yu-Hsien Lin, 1Hwang-Chi Lin, 2Sheng-Po Hao 1Division of Plastic Surgery, Department of Surgery; 2Department of Otolaryngology Head and Neck Surgery;

Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

The authors have no commercial associations

information presented in this article. No funding was received for this work.

Objective of the study

฀1. hypopharynygeal cancer was preferred

to be performed surgical intervention

฀2. Our novel design of

tubed parallelogram free ALT flap

฀3. Chimeric flap was designed for flap

monitoring

฀4. results of our patients

Materials – Case

฀65 y/o male

฀ dysphagia and easily choking ฀ for about 1 month

฀Diagnosis:

Hypopharyngeal cancer cT4aN1M0, stage IVA SCC

the defect after total pharyngectomy

7 cm 10 cm

Methods

฀1. our design:

parallelogram free ALT flap

฀2. tubing with using 50c.c. synringe ฀3. chimeric design:

฀ muscle+ fasciocutaneous ฀ fasciocutaneous+ fasciocutaneous

Reconstruction after pharyngectomy

Our design: parallelogram free ALT flap

parallelogram free ALT flap

10 cm 7 cm <8 cm

Tubing Tubing with using 50c.c. synringe

diameter of 3 cm

2πr≈10 cm

Flap monitoring:

chimeric design

Results: the donor site

primary closure

Results clinical course

try water

removed NG

liquid diet

soft diet discharged admissio n OP

Esophagography (2/17): no leakage

฀1. parallelogram design of free ALT flap is

alternative choice for reconstruction after pharyngectomy

฀2. similar functional results

as tranditional design

฀3. primary closure for donor site

Conclusions:

In our hospital, F/u till Apr,2014

฀Hypopharyngeal cancer

s/p wide excision + reconstruction ฀ From 2010/4 to 2014/2 ฀ Total of 13 patients: ฀ Soft diet: n=7 (54%) ฀ Liquid diet: n=3 (23%) ฀ Nil: n=3 (23%)

฀Welcome to Taipei!

Taiwan!

฀Thanks for your attention!