Voice prosthesis related expanding tracheoesophageal puncture repair: microsurgical reconstruction to pedicled pectoralis major muscle flap

  • Mahendra Daya University of KwaZulu-Natal
  • Desigan Pillay University of KwaZulu-Natal
Keywords: Expanding tracheoesophageal puncture, Voice prosthesis complications, Pectoralis major myofascial flap

Abstract

Insertion of voice rehabilitation devices (VRD) via tracheoesophageal punctures (TEP) post laryngectomy is considered the standard of care. The management of periprosthetic leakage from the puncture site in a zone of previous neck dissection and or radiotherapy is problematic when it results in a tracheoesophageal fistula (TOF), as simple surgical closure and use of tissue for flaps carries a high risk of failure. We share our clinical experience in 3 of 42 patients who had a laryngectomy and VDR, who developed an expanding TEP with failure of free flaps in two, and the utility of a narrow pectoralis major myofascial flaps (PMMF) as a universally successful salvage or primary procedure.

Author Biographies

Mahendra Daya, University of KwaZulu-Natal

Department of Plastic and Reconstructive Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
Durban, South Africa

Desigan Pillay, University of KwaZulu-Natal

Department of Plastic and Reconstructive Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
Durban, South Africa

Published
2018-11-08
How to Cite
Daya, M., & Pillay, D. (2018). Voice prosthesis related expanding tracheoesophageal puncture repair: microsurgical reconstruction to pedicled pectoralis major muscle flap. South African Journal of Surgery, 56(4), 51. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2336
Section
Case Reports