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Case Reports
. 2021 Jul 14:2021:6619916.
doi: 10.1155/2021/6619916. eCollection 2021.

Use of Supraclavicular Flap by End to Side Technique in Pharyngeal SCC: A Case Report and Review of Literature

Aslan Ahmadi  1   2 , Ayda Sanaei  1   2 , Delaram Jan  1   2 , Maryam Zolfaghary  1   2
Affiliations
Case Reports

Use of Supraclavicular Flap by End to Side Technique in Pharyngeal SCC: A Case Report and Review of Literature

Aslan Ahmadi et al. Case Rep Otolaryngol. .

Abstract

Objectives: In recent years, conservation laryngeal surgeries, including partial pharyngectomy, have been introduced as an alternative procedure for selected cases of hypopharyngeal squamous cell carcinoma (HSCC). Reconstruction of these defects presents a considerable challenge for the surgeon after partial pharyngectomy due to its circumferential nature. In this case report, we represent the innovative "End to side" technique to reconstruct hypopharyngeal defect using the rolled supraclavicular flap after laryngeal-preserving partial pharyngectomy.

Methods and results: A 70-year-old female presented with a history of progressive dysphagia and odynophagia. The evaluations revealed a T3N0M0 SCC of pyriform sinus. The mass was successfully resected through partial pharyngectomy, and the hypopharyngeal defect reconstruction was achieved using the rolled supraclavicular flap via the "End to side" technique. The patient was discharged after decannulation on day 10. The 3-week barium swallow was performed with no evidence of anastomotic leakage, and the oral feeding was started after NG tube removal. At week 5, complete movement of the true vocal cord on the one side and good phonation and deglutition was observed. There was no evidence of recurrence after 1 year.

Conclusions: Laryngeal-preserving partial pharyngectomy and hypopharyngeal reconstruction with the rolled supraclavicular flap via the "End to side" technique could lead to good oncological and functional outcomes in selected cases of pyriform sinus.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
CT scan, axial view. There is an abnormal enhancing mass in the left pyriform sinus.
Figure 2
Figure 2
The rolled flap was advanced and connected (using modified Gambee suture) to pharyngeal wall to provide additional mucosa to cover the defect.
Figure 3
Figure 3
Short arrow indicates anastomosis of flap to oropharynx in proximal. Long arrow indicates anastomosis of rolled flap to cervical esophagus in distal part of the defect.
Figure 4
Figure 4
External view of the neck. Flash showing the supraclavicular flap pedicle, demonstrating a viable flap after 2 months of surgery.
Figure 5
Figure 5
Examination of the pharyngeal entrance and supraclavicular flap using fiber-optic, after 2 months of surgery. The long arrow indicates supraclavicular flap and the short arrow indicates new pharyngeal lumen input.
See this image and copyright information in PMC

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