Reconstructive Flaps After Salvage Nasopharyngectomy
Journal Title: Otolaryngology – Open Journal - Year 2016, Vol 2, Issue 1
Abstract
Importance: The emergence of new technologies for early diagnosis of recurrent nasopharyngeal cancer and new techniques of endoscopic nasopharyngectomy increase the incidence of salvage nasopharyngectomy and pose the question of the ideal flap for reconstruction of this defect. Objectives: A review of the literature to identify the flaps used in nasopharyngeal reconstruction and their advantages and disadvantages, characteristics, and outcomes. Methods: We reviewed the literature available in the English language to identify the various flaps used, their indications and surgical technique, complications and outcomes. Results: Multiple flaps have been used. Local mucosal flaps such as the posterior pedicled middle turbinate mucoperiosteal flap, the posterior pedicled Nasal Septal Flap (NSF) and Floor mucoperiosteum flap (FF), pedicled flaps such as the extended glabellar fascial cutaneous flap, the Haddad-Bassagasteguy flap, the temporoparietal fascial flap and the pericranial flap and free flaps such as the radial forearm and vastus lateralis flap have been described. These flaps are used depending on the specific defect characteristics and tissue available for reconstruction. The advantages and disadvantages of these flaps are discussed. Conclusion: No single flap is ideal for all cases. The choice of flap will have to be tailored according to the patient, the defect created, consistent with oncologic principles, donor site availability and surgeon preference. A working knowledge of available flaps is essential to provide coverage of the skull base to avoid vascular and infectious complications.
Authors and Affiliations
Punam G. Thakkar
Keywords
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- EP ID EP546694
- DOI 10.17140/OTLOJ-2-107
- Views 141
- Downloads 0
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