Evidence map›Paper›PMID 32377856›Full record

ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2020

Closing of large pharyngostomes with free flaps and proposal of a new classification.

J L Llorente, P Sánchez, F López, D Camporro, A Fueyo, R Charlone, J P Rodrigo, C Álvarez-Marcos

Abstract readReview
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In one paragraph

Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A systematic review of surgical outcomes and postoperative complications based on free flap selection for reconstructing primary or recurrent locally advanced laryngeal-hypopharyngeal tumours.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2026
    Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

J L LlorenteDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain.
P SánchezDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain. psfernan90@hotmail.com.ORCID http://orcid.org/0000-0002-6223-465X
F LópezDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain.
D CamporroDepartment of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.
A FueyoDepartment of Plastic Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.
R CharloneDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain.
J P RodrigoDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain.
C Álvarez-MarcosDepartment of ENT, Hospital Universitario Central de Asturias, C/Avenida de Roma s/n, 33011, Oviedo, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLarge pharyngocutaneous fistulas or pharyngostomes are difficult complications to solve, which generate high morbidity and mortality, a poor quality of life and an increase in health costs. Its management must be comprehensive according to general, local and regional factors. We review our experience in treating these pharyngostomes with free flaps.

methodsRetrospective study analyzing the results of the reconstruction of 50 patients using free flaps during the period 1991-2019. We exclude patients who required free-flap reconstruction due to primary tumor or those who resolved in other ways. The different types of reconstruction were classified into three types.

resultsThe 86% (43) were men, and the mean age was 57 years (25-76). In 48% (24/50) the flaps performed were anterolateral thigh (ALT), in 24% (12/50) forearm, in 22% (11/50) parascapular, in 4% (2/50) jejunum and in 2% (1/50) ulnar. A salivary by-pass was placed in 74% (37/50) of the cases. Four cases (8%) presented flap necrosis and two patients died due to treatment. In 86% (43/50) there was some type of complication and 34% (17/50) required surgical revision. 94% (45/48) were able to reintroduce oral feeding.

conclusionAccording to our experience, we proposed a regardless size classification: type 1 when only a mucous closure (pharynx) are required (6%), type 2 exclusively skin for cutaneous coverage (10%) and mixed type 3 (mucous and skin) (84%). The treatment of large pharyngostomes with free flaps, despite its complexity, is in our experience the best option for its management.

Indexed as

Free Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresFemaleHumansMaleMiddle AgedQuality of LifeRetrospective StudiesThighTreatment OutcomeFree flaps in head and neckHead and neck reconstructionPharyngocutaneous fistulaPharyngolaryngectomyPharyngostomes

Identifiers

PMID32377856

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.