Preservation of the larynx after resection of a carcinoma of the posterior wall of the hypopharynx: versatility of a free flap patch graft.

Abstract

Preservation of the larynx after resection of a pharyngeal tumor remains a challenging problem for the head and neck surgeon. Nine patients with T1 or T2 carcinoma of the posterior wall of the hypopharynx (UICC 1987), who were treated surgically between 1984 and 1994, were studied. All patients underwent surgical resection of the tumor with laryngeal preservation and immediate reconstruction with free flap transfer. A free forearm flap was transferred in four patients and a free jejunal patch graft, in five patients. There was one flap loss, due to venous thrombosis. Successful larynx preservation was achieved in the remaining eight patients (89%). Although there was one local control failure, three patients remained free of disease for more than 5 years. Laryngeal preservation surgery using a free flap patch graft has proven very beneficial in selected cases with a carcinoma of the posterior wall of the hypopharynx.