VIBRATORY SEGMENT FUNCTION AFTER FREE-FLAP RECONSTRUCTION OF THE PHARYNGOESOPHAGUS

Reconstructive options following total laryngopharyngectomy include th in, pliable free tissue segments, approximating the natural thickness of the pharyngeal wall. The authors have investigated outcomes in the following clinical series, emphasizing speech and swallowing. Twelve c ancer patients underwent laryngopharyngectomy with or without glossect omy, Eight jejunal, 1 radial forearm, and 3 innervated latissimus dors i flaps were used for vibratory segment (VS) reconstruction, and all 1 2 patients underwent tracheoesophageal puncture (TEP). Eleven patients achieved intelligible speech, with a median intelligibility of 93%. T he vibrating segments showed fluttering of the free flap tissue when s tudied by videopharyngography. Vocal quality was lower pitched and sof ter than ''conventional'' TEP speech. Ah patients achieved oral intake as their primary mode of nutrition. Free flaps are a successful optio n for VS reconstruction in patients undergoing larynopharyngectomy or glossopharyngolaryngectomy, obviating the need for written or electrol arynx communication.