POSTERIOR PHARYNGEAL CARCINOMA RESECTION WITH LARYNX PRESERVATION ANDRADIAL FOREARM FREE-FLAP RECONSTRUCTION - A PRELIMINARY-REPORT

Background: Surgical management of selected posterior pharyngeal wall lesions can be performed with pharyngectomy, allowing for larynx prese rvation, with radial forearm free flap (RFFF) reconstruction. Methods: Retrospective review of our experience using RFFF reconstruction in 9 patients. Results: All 9 patients had a posterior pharyngectomy with larynx preservation, neck dissection (3 bilateral, 6 unilateral), and RFFF reconstruction. Six patients experienced 8 postoperative complica tions including one postoperative death. Only 3 patients were able to obtain all nutrition orally. Tracheotomy decannulation occurred in 4 p atients and voice was maintained in all patients. American Society of Anesthesiologists score (ASA) was an accurate predictor of postoperati ve medical complications. Conclusions: Posterior pharyngeal resections with larynx preservation and RFFF reconstruction can be accomplished with acceptable morbidity in healthy patients with carefully selected lesions of the posterior pharyngeal wall, However, in patients with si gnificant co-morbidities as reflected by an ASA of 3 or more, larynx p reservation and RFFF reconstruction was fraught with significant morbi dity and is not recommended.