Am J Otolaryngol Head Neck Surg | Volume 5, Issue 9 | Research Article | Open Access

Heterogeneous Acellular Dermal Matrix Combined with Infrahyoid Muscles Flap for Reconstruction of Laryngopharynx in Pyriform Sinus Carcinoma

Chen M# , Zhang C# , Yao H, Li H, Zheng H and Zhu M*

Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, PR China

*Correspondance to: Minhui Zhu 

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Abstract

Background: Many methods of laryngopharyngeal reconstruction after extended laryngopharyngectomy have been described, but the functional outcomes and morbidities have not been satisfactory. The objective of the study was to evaluate the outcomes of laryngopharyngeal reconstruction with Heterogeneous Acellular Dermal Matrix (H-ADM) combined with infrahyoid muscle reinforcement. Methods: From 2014 to 2018, 7 patients with T2–T3 squamous cell carcinoma of the pyriform sinus were included in this retrospective study. Reconstruction of laryngopharyngeal defects was performed using H-ADM combined with infrahyoid muscle graft after tumor resection. The functional and oncological outcomes were evaluated at follow-up greater than 3 years. Results: Resection of the pyriform sinus and infiltrated hemilarynx was performed in all patients. The diameter of the defect after laryngopharyngectomy was less than 6 cm. During 30 to 60 days after reconstruction, the H-ADM was covered with normal mucosa. One patient developed a pharyngeal fistula one-week post-operation, but recovered after dressing change about 2 months. No other severe postoperative complication occurred. Patients recovered normal swallowing function at a mean of 21.5 days after surgery. Laryngeal function was preserved in all patients, and decannulation was performed at a mean of 12.3 weeks after the surgery. The follow-up period ranged from 39 to 53 months, the overall 3-year survival rate was 71.4%, and the local-control rate was 57.1%. Conclusion: H-ADM combined with infrahyoid muscles flap is a simple, safe and effective method of reconstruction after pyriform sinus resection. This technique offers a novel alternative for these patients with normal swallowing function, and a relatively acceptable survival duration.

Keywords:

Biocompatible materials; Hypopharyngeal neoplasms/surgery; Surgical flaps; Heterogeneous acellular dermal matrix; Infrahyoid muscle; Reconstruction; Pyriform sinus carcinoma

Citation:

Chen M, Zhang C, Yao H, Li H, Zheng H, Zhu M. Heterogeneous Acellular Dermal Matrix Combined with Infrahyoid Muscles Flap for Reconstruction of Laryngopharynx in Pyriform Sinus Carcinoma. Am J Otolaryngol Head Neck Surg. 2022; 5(9): 1211..

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