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In the reconstruction of a pharyngeal defect after ablative surgery for head and neck cancer, free flaps are currently the most common method because of their versatility. However, elderly patients or debilitated cases sometimes hesitate to have free flaps applied because morbidity can lead to critical results. We present a case of hypopharyngeal carcinoma in which we performed total laryngectomy with partial pharyngectomy followed by reconstruction using a cervical pedicled flap, a submental island flap. Case: An 81-year-old man presented with T4aN1M0 squamous cell carcinoma of the right pyriform sinus that extended to the posterior wall of the hypopharynx, larynx, and infrahyoid muscles over the lamina of thyroid cartilage. Additionally, the patient had preoperative severe malnutrition and anemia. Right selective neck dissection, total laryngectomy with partial pharyngectomy, and reconstruction using a submental island flap were performed. The patient was ambulatory the day after surgery and resumed oral intake on the 10th postoperative day. Neither flap necrosis nor anastomotic leakage has been recognized. The submental island flap is thought to be a useful option for pharyngeal reconstruction as an alternative to free flaps.
特定非営利活動法人日本頭頸部外科学会の論文