Variation of free jejunal grafts for reconstructions of oropharyngeal defects

Introduction: Resections of extensive tumours, recurrences and radiodermati tides at the neck cause complex defects. Free bowel transplantation enables one-stage reconstruction. Patients and Methods. In 35 out of 57 interdisci plinarily treated patients, small-bower transplantation was performed for r econstruction. Thirty patients received cylinder grafts, five jejunal patch plastics. In four patients neoglottis formations according to Ehrenberger were performed. To cover soft tissue defects, two patients received scapula r free flaps, eight patients a jejunal segment, incised at the anti-mesente ric side, the mucosa stripped and covered by a split skin graft. Results an d Conclusions: Thirty-four grafts were viable. One patient received a succe ssful re-transplantation. One postoperative fistula at the hypo-pharyngojej unostomy was closed by a seperated jejunal segment which was primarily used as monitor, two others by pectoral flaps. Separation of a jejunal graft in to two or three segments enables restoration of swallowing, voice and cover ing soft tissue in a one-stage procedure. The whole reconstruction necessit ates only one arterial and one venous microanastomosis at the neck.