抄録
Dysphagia after total laryngectomy is rare. Even when it occurs, it often improves with bougienage or endoscopic treatment by an otolaryngologist. However, in the present case, the patient’s dysphagia was severe and progressive owing to the effects of radiation therapy, prompting consultation with reconstructive surgery. The contracted pharyngeal mucosa was released under direct visualization, and well-vascularized flap transplantation was performed. Pectoralis major myocutaneous flap reconstruction using a strip of the posterior pharyngeal mucosa has maintained a good swallowing function over the long term.
A: Preoperative neck appearance. The skin of the anterior neck is thin and stiff. B: Preoperative swallowing videofluorography. An hourglass-shaped narrowing is observed in the hypopharyngeal region at 8 cm (yellow arrow). C: Preoperative contrast-enhanced computed tomography image. The thickness of the soft tissue overlying the common carotid artery was 2 mm. No commonly used arteries, such as the superior thyroid, transverse cervical, or facial arteries, were identified as potential graft vessels.
