SynthesisEuropean 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 Surgery2025
Use of double flaps in pharyngo-laryngo-esophageal reconstructions: a retrospective review.
Synthesis 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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
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Abstract
purposeThis article aims to review techniques and applications for using double flaps (both free and pedicled, and their combinations) in reconstructing defects from total pharyngolaryngectomies (TPL) or pharyngolaryngo-esophagectomies.
methodsThis systematic review followed PRISMA 2020 guidelines. Three authors screened articles, selecting and extracting data on malignancy characteristics, reconstructive techniques, outcomes and complications.
resultsEleven articles were reviewed, involving 176 oncologic patients. Most patients (39.8%) had defects in the larynx, hypopharynx and cervical skin, while in 31.8% the double flaps were used to restore the pharynx and protect the visceral anastomosis. In most studies included, preoperative treatments were administered, including radiotherapy (RT), concurrent chemoradiotherapy (CRT), and surgery, either alone or in combination. A wide variety of pedicled and free flaps were described. The most common pedicled flap is the pectoralis flap (81 patients, 46%), while the most used free flap is the jejunum flap (124 patients, 70%). 19 patients (10.8%) manifested partial necrosis or encountered minor complications postoperatively. 5 patients necessitated a surgical revision of the flap.
conclusionThe literature on surgical reconstructions following TPL or pharyngolaryngo-esophagectomies using double flaps is limited. The use of double flap is indicated in cases of TPL with extensive skin defect but is also recommended in case of salvage TPL without skin defect.
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