THE LONGUS COLLI MUSCLE FLAP FOR RECONSTRUCTION OF THE LATERAL PHARYNGEAL WALL

Background. Full-thickness lateral pharyngeal wall (LPW) defects are d ifficult to reconstruct, whether the larynx is preserved or removed (e xtended total laryngectomy). FI simple, reliable reconstructive method using local tissue which optimizes wound healing and functional resul ts would allow partial laryngectomy more often, without incurring the cost, donor site morbidity, and increased operative length of regional or free flaps, My objective was to propose use of the longus colli mu scle as a reconstructive flap for defects of the LPW. Methods. Results of using the longus colli muscle flap (LCMF) in a series of 16 patien ts with primary tumors of the pharyngeal wall or pyriform sinus are pr esented. The majority had surgery and planned postoperative radiothera py. Results. There were no wound infections or fistulas. One of 2 prev iously radiated patients had a transient wound-healing problem. Althou gh 88% of the patients were stage III and IV and 50% had T3-4, primary tumors, there were only 2 local failures, for a local control rate of 88%. Corresponding cancer-free survival was 69% (median follow-up of 22 months). Two thirds of the patients took all or some food by mouth, and of the 12 with larynx preserved, 58% were decannulated, and 11 ha d a good to normal voice. Conclusions. The reliability of wound healin g and absence oi negative impact on oncologic and functional results v alidate use of the LCMF as a reconstructive option for defects in the LPW at both the oropharynx and hypopharynx levels. (C) 1997 John Wiley & Sons, Inc.