Liberal Use of Pectoralis Major Muscle Flap Reduces Incidence ofPharyngocutaneous Fistula Following Salvage Laryngectomy

Abstract

Patients undergoing salvage laryngectomy following chemoradiotherapy are more vulnerable to develop pharyngocutaneous fistula. This isdue to fibrosis and reduced vascularity that results in poor postoperative healing. We are presenting a simple technique that can reduce thisdistressing complication. In patients where primary closure cannot be achieved, myocutaneous flap to reconstruct the pharynx reduces theincidence of postoperative complications. Similarly, buttressing of the suture line with the pectoralis major myofacial flap has been shown toreduce the fistula rates. Needless to say that pectoralis major muscle flap is a robust flap with acceptable complication rates.