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Closure of tracheoesophageal fistula with prefabricated revascularized bilaminar radial forearm free flap

✍ Scribed by Volkert B. Wreesmann; Ludi E. Smeele; Frans J. M. Hilgers; Peter J. F. M. Lohuis


Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
222 KB
Volume
31
Category
Article
ISSN
1043-3074

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✦ Synopsis


Abstract

Background

Tracheoesophageal fistula (TEF) is a rare but serious complication associated with high mortality rates. Traditional management of TEF includes primary closure with or without interposition of regional tissue flaps but is associated with a significant recurrence risk, especially in case of larger fistulas. Application of microvascular free flap reconstruction is an emerging alternative in the surgical management of large TEFs, but may be limited by issues of flap bulkiness and requirement for neoepithelialization across the large inner flap surface.

Methods and Results

Here, we report prefabrication of a bilaminar radial forearm free flap to successfully close a large recurrent TEF that occurred years after tracheoesophageal puncture‐based voice rehabilitation in a laryngectomized patient.

Conclusion

The bilaminar radial forearm free flap may prove to be an important adjunct to the closure of large TEFs. © 2008 Wiley Periodicals, Inc. Head Neck, 2009