New options for aerodigestive tract replacement after extended pharyngolaryngectomy

Objectives: Assess the results of a new type of reconstruction of the aerod igestive tract after extended pharyngolaryngectomy. Study Design: Follow-up of a total of eight patients who had surgery using ileocolic free graft. M ethods: The surgical technique is described. Five patients underwent pharyn golaryngectomy/cervical esophagectomy, and three patients had total larynge ctomy with subtotal pharyngectomy. Patients were monitored to assess compli cations and recovery of satisfactory swallowing and speech. Results: The te chnique, thanks to the use of material from the colon, proved to be extreme ly useful for the reconstruction of the digestive tract. At the same time, ileal anastomosis with the tracheal stump enabled aerodigestive crossing re storation, protected by the ileocecal valve. All patients recovered good sw allowing capacity and phoniatric expression, which mere obtained by digital occlusion of the tracheostomy, forcing the expiratory air through the ileu m and ileocecal valve. Manometric tests also showed that after a while ther e was a gradual synchronization of swallowing between the transplanted coli c segment and the residual esophagus, Conclusions: The technique described in the present study may be regarded, also in the light of possible further applications, as a new and interesting option for the reconstruction of th e aerodigestive tract.