Prefabricated Supraclavicular Flap as a Salvage Procedure for a Failed Microvascular Hypopharyngeal Defect Closure in a Tetraplegic Patient
| Autor: | G. Till Fischborn, Andreas B. Schmidt, Goetz A. Giessler |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Perforation (oil well) Quadriplegia Free Tissue Flaps Humans Medicine Fibula Tetraplegia Salvage Therapy medicine.diagnostic_test business.industry medicine.disease Surgery Endoscopy Hypopharynx Plastic surgery Spinal Fusion medicine.anatomical_structure Spinal fusion Flexor hallucis longus muscle business Artery |
| Zdroj: | Annals of Plastic Surgery. 67:245-250 |
| ISSN: | 0148-7043 |
| Popis: | Delayed hypopharyngeal perforations in tetraplegics are a rare but potentially life-threatening complication of anterior cervical spine instrumentation. To date, no established treatment regimen exists for these situations. A patient with traumatic tetraplegia sub-C4 was admitted to the hospital 14 days after anterior spinal fusion with an infected hypopharyngeal perforation. After hardware removal, the spine was restabilized with a composite free osteomusculocutaneous fibula with the flexor hallucis longus muscle closing the mucosal defect. However, it was lost because of external venous compression. After 54 days, definitive reconstruction was achieved with a delayed supraclavicular artery flap. Follow-up endoscopy showed a closed and mucosalized defect. Composite free flaps are intriguing for complex hypopharyngeal and spine defects; however, they can undergo fatal external compression due to postoperative swelling in this area. Supraclavicular flaps might serve as a rescue alternative, offering unimpaired neck mobility that is crucial for tetraplegics, adequate tenuity for the hypopharynx, and reliable blood supply without large vessels in the field. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|