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Planned simultaneous cervical skin reconstruction for salvage total pharyngolaryngectomy.

BACKGROUND
Salvage surgery after definitive radiotherapy with or without chemotherapy is still controversial, especially in cases of hypopharyngeal cancer because of the poor prognosis and surgical complications. Irradiation of the skin results in loss of flexibility of the skin and impairment of the normal healing processes, thereby increasing the risk of wound infections, which could be potentially life-threatening. In an attempt to diminish the risk of major complications, we performed planned cervical skin replacement with salvage total pharyngolaryngectomy (TPL).


METHODS
From 2005 to 2006, six patients underwent salvage TPL and cervical reconstruction with a deltopectoral flap at our hospital. The cervical skin replacement was determined pre-operatively and not according to the intraoperative status.


RESULTS
There were no major post-operative complications. Both the prolongation of the operation time and of the duration of hospitalization were within acceptable limits.


CONCLUSION
Planned cervical skin reconstruction appears to be an appropriate and acceptable procedure with salvage pharyngolaryngectomy to avoid major complications.