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  • Title: [Pharyngeal fistula after irradiation and laryngectomy. Problem of the reconstruction of the pharynx].
    Author: Piza-Katzer H, Grasl MC, Pecoraro K, Roka R.
    Journal: HNO; 1988 Mar; 36(3):123-6. PubMed ID: 3360633.
    Abstract:
    A 39-year-old patient with an epiglottic carcinoma stage T4N2M0 was treated initially by radiotherapy, but later underwent laryngectomy for irradiation necrosis. A pharyngeal fistula occurred in the irradiated area. After resection of the damaged skin reconstruction was performed by a double skin paddle myocutaneous pectoralis major flap. A recurrence of the fistula in the same area was closed by invagination of the flap. Three years later a massive scar stenosis developed in the reconstructed hypopharynx, so that the patient was unable to swallow. This required a total resection of the scar tissue which extended from the entrance of the hypopharynx to the upper oesophageal sphincter. The gap was bridged by a free microvascular jejunal graft. To date 6 months have elapsed since this operation and the patient is symptom free.
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