Clinical cases of using a supraclavicular flap for closure of a circular defect of the pharynx and cervical esophagus

• Main Authors: I. A. Togo, A. V. Karpenko, R. R. Sibgatullin, A. A. Boyko
• Format: Article
• Language: Russian
• Published: ABV-press 2018-07-01
• Series: Opuholi Golovy i Šei
• Subjects: head and neck tumors; laryngeal cancer; cancer of the cervical esophagus; circular defect; island supraclavicular defect
• Online Access: https://ogsh.abvpress.ru/jour/article/view/349
• ISSN: 2222-1468; 2411-4634

Defects after laryngopharyngectomies create a complex esthetics and functional problem. In this article, we present clinical cases of using a supraclavicular island flap for closing defects after surgical treatment of neck tumors. In the 1st case, a female patient with poorly differentiated squamous-cell carcinoma of the laryngopharynx underwent modified radical neck dissection on the right, laryngopharyngectomy with pharyngeal reconstruction using a fasciocutaneous supraclavicular flap. In the postoperative period, marginal necrosis of the deltopectoral flap developed but it healed by secondary intention. Control X-ray of the esophagus with barium sulfate showed that the pharynx transplant was functioning, anastomosis with the esophagus was consistent.In the 2nd case, a male patient with cancer of the vestibular larynx underwent surgical (tracheostomy, laryngectomy, modified radical neck dissection) and radiation treatment. During follow-up monitoring, a parastomal recurrence was detected which was removed with trachea resection, circular resection of  the cervical esophagus, removal of  the  right lobe of  the  thyroid, and combined defect reconstruction using a  fasciocutaneous supraclavicular flap (circular esophageal defect) and a pectoralis major myocutaneous flap. Postoperative period was complications-free. Control X-ray showed transplant patency and anastomosis consistency.Therefore, the use of a supraclavicular flap is one of possible variants for closure of circular pharyngeal and esophageal defects and an alter-native for free revascularized flaps in cases where they can’t be used.