β Scribed by Geoffrey L. Robb; Jan S. Lewin; Daniel G. Deschler; Bruce H. Haughey; Dale H. Brown; Susan E. Langmore; Jan S. Lewin
No coin nor oath required. For personal study only.
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 cm in length. A left anterolateral thigh fasciocutaneous flap was raised based on a single cutaneous perforator (Figure 1C andD). The right superior thyroid artery was used as a recipient artery. The pedicle vein was anastomosed to a branch of the internal jugular vein with a 3-mm vein coupler. Part of the flap was de-epithelialized and folded onto itself to provide more bulk for the base of the tongue (Figure 1E). The distal flap skin was externalized above the tracheostomy for flap monitoring (Figure 1F).
Considering the pharyngeal defect now present:
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