โ Scribed by Desanto, Lawrence W. ;Carpenter, Robert J.
No coin nor oath required. For personal study only.
Construction of a new gullet after circumferential resection of the pharynx and upper portion of the esophagus for cancer is a major challenge to the head and neck surgeon. Techniques for reconstruction use cervical skin, adjacent pedicle flaps, and interposed visceral segments. Each technique has its place; none is ideal or free from complication or failure. Cure rates are poor, and unsolved problems remain. The quest for the perfect technique must continue, but the ultimate solution rests not with reconstruction techniques but with earlier diagnosis and elimination of the need for reconstruction.
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A 70-year-old man was initially seen with recurrent laryngeal cancer after therapeutic irradiation and with a second primary tumor in the base of the tongue. He underwent bilateral neck dissections, resection of the base of the tongue, and total laryngectomy (Figure 1A andB). The defect measured 9 c
## Abstract Since the advent of the jejunal free flap in the early 1900s, it has become one of the most effective and widely used methods for reconstruction of circumferential defects of the esophagus, often due to malignant disease. However, as esophageal resections extend further cranially, recon
112 infrahyoid myocutaneous flaps (IHMCFs) were used for reconstruction of the tongue after resection of lingual carcinoma (67 flaps in 63 consecutive cases) and for repair of defects after resection of carcinomas of buccal mucosa (23 cases), floor of mouth (8 cases), parotid gland (7 cases), and ot