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Semin Plast Surg 2023; 37(01): 031-038
DOI: 10.1055/s-0042-1759796
DOI: 10.1055/s-0042-1759796
Review Article
Neopharyngeal Stricture following Laryngectomy
Krishna S. Hanubal
1
College of Medicine, University of Florida, Gainesville, Florida
,
Neil N. Chheda
2
Department of Otolaryngology, University of Florida, Gainesville, Florida
,
Peter T. Dziegielewski
2
Department of Otolaryngology, University of Florida, Gainesville, Florida
3
University of Florida Health Cancer Center, Gainesville, Florida
› Institutsangaben
Abstract
Stricture formation is a serious complication following pharyngeal reconstruction. These strictures can be life-threatening and can severely impact quality of life. In this article, the existing literature on surgical risk factors linked to neopharyngeal stricture formation is reviewed. Intraoperative preventative measures reconstructive surgeons should consider are also discussed. Finally, this article will describe the evaluation and management of pharyngoesophageal strictures, including the challenges and options when dealing with refractory strictures.
Publikationsverlauf
Artikel online veröffentlicht:
22. Dezember 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Harris BN, Hoshal SG, Evangelista L, Kuhn M. Reconstruction technique following total laryngectomy affects swallowing outcomes. Laryngoscope Investig Otolaryngol 2020; 5 (04) 703-707
- 2 Landera M, Lundy D, Sullivan P. Dysphagia after total laryngectomy. Perspect Swallowing Swallowing Disord 2010; 19 (02) 39-44
- 3 Piotet E, Escher A, Monnier P. Esophageal and pharyngeal strictures: report on 1,862 endoscopic dilatations using the Savary-Gilliard technique. Eur Arch Otorhinolaryngol 2008; 265 (03) 357-364
- 4 Balfe DM, Koehler RE, Setzen M, Weyman PJ, Baron RL, Ogura JH. Barium examination of the esophagus after total laryngectomy. Radiology 1982; 143 (02) 501-508
- 5 Samlan RA, Webster KT. Swallowing and speech therapy after definitive treatment for laryngeal cancer. Otolaryngol Clin North Am 2002; 35 (05) 1115-1133
- 6 Terlingen LT, Pilz W, Kuijer M, Kremer B, Baijens LW. Diagnosis and treatment of oropharyngeal dysphagia after total laryngectomy with or without pharyngoesophageal reconstruction: systematic review. Head Neck 2018; 40 (12) 2733-2748
- 7 Yeh DH, Sahovaler A, Fung K. Reconstruction after salvage laryngectomy. Oral Oncol 2017; 75: 22-27
- 8 Schuman AD, Birkeland AC, Farlow JL. et al. Predictors of stricture and swallowing function following salvage laryngectomy. Laryngoscope 2021; 131 (06) 1229-1234
- 9 Iteld L, Yu P. Pharyngocutaneous fistula repair after radiotherapy and salvage total laryngectomy. J Reconstr Microsurg 2007; 23 (06) 339-345
- 10 Wang JJ, Goldsmith TA, Holman AS, Cianchetti M, Chan AW. Pharyngoesophageal stricture after treatment for head and neck cancer. Head Neck 2012; 34 (07) 967-973
- 11 Hui Y, Wei WI, Yuen PW, Lam LK, Ho WK. Primary closure of pharyngeal remnant after total laryngectomy and partial pharyngectomy: how much residual mucosa is sufficient?. Laryngoscope 1996; 106 (04) 490-494
- 12 Walton B, Vellucci J, Patel PB, Jennings K, McCammon S, Underbrink MP. Post-laryngectomy stricture and pharyngocutaneous fistula: review of techniques in primary pharyngeal reconstruction in laryngectomy. Clin Otolaryngol 2018; 43 (01) 109-116
- 13 Vu KN, Day TA, Gillespie MB. et al. Proximal esophageal stenosis in head and neck cancer patients after total laryngectomy and radiation. ORL J Otorhinolaryngol Relat Spec 2008; 70 (04) 229-235
- 14 Hasan Z, Dwivedi RC, Gunaratne DA, Virk SA, Palme CE, Riffat F. Systematic review and meta-analysis of the complications of salvage total laryngectomy. Eur J Surg Oncol 2017; 43 (01) 42-51
- 15 Sweeny L, Golden JB, White HN, Magnuson JS, Carroll WR, Rosenthal EL. Incidence and outcomes of stricture formation postlaryngectomy. Otolaryngol Head Neck Surg 2012; 146 (03) 395-402
- 16 Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck 2012; 34 (04) 580-588
- 17 Cabrera CI, Joseph Jones A, Philleo Parker N, Emily Lynn Blevins A, Weidenbecher MS. Pectoralis major onlay vs interpositional reconstruction fistulation after salvage total laryngectomy: systematic review and meta-analysis. Otolaryngol Head Neck Surg 2021; 164 (05) 972-983
- 18 Gilbert MR, Sturm JJ, Gooding WE, Johnson JT, Kim S. Pectoralis major myofascial onlay and myocutaneous flaps and pharyngocutaneous fistula in salvage laryngectomy. Laryngoscope 2014; 124 (12) 2680-2686
- 19 Ziegler A, Pittman A, Thorpe E. Salvage total laryngectomy swallowing outcomes based on flap reconstruction: onlay vs incorporated technique. Otolaryngol Head Neck Surg 2021; 165 (06) 827-829
- 20 Tsou YA, Lin MH, Hua CH, Tseng HC, Bau DT, Tsai MH. Comparison of pharyngeal stenosis between hypopharyngeal patients undergoing primary versus salvage laryngopharyngectomy. Otolaryngol Head Neck Surg 2010; 143 (04) 538-543
- 21 Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 1979; 63 (01) 73-81
- 22 Ki SH, Choi JH, Sim SH. Reconstructive trends in post-ablation patients with esophagus and hypopharynx defect. Arch Craniofac Surg 2015; 16 (03) 105-113
- 23 Demirtas Y, Yagmur C, Kelahmetoglu O, Demir A, Guneren E. Transaxillary-subclavian transfer of pedicled latissimus dorsi musculocutaneous flap to head and neck region. J Craniofac Surg 2010; 21 (03) 771-775
- 24 Hayden RE, Kirby SD, Deschler DG. Technical modifications of the latissimus dorsi pedicled flap to increase versatility and viability. Laryngoscope 2000; 110 (3 Pt 1): 352-357
- 25 Amin AA, Rifaat M, Ellabban MA, Zedan M, Kamel M, Bassiouny M. Transaxillary thoracodorsal artery perforator flap: a versatile new technique for hypopharyngeal reconstruction. J Reconstr Microsurg 2014; 30 (06) 397-404
- 26 Heitmann C, Guerra A, Metzinger SW, Levin LS, Allen RJ. The thoracodorsal artery perforator flap: anatomic basis and clinical application. Ann Plast Surg 2003; 51 (01) 23-29
- 27 Hamdi M, Van Landuyt K, Hijjawi JB, Roche N, Blondeel P, Monstrey S. Surgical technique in pedicled thoracodorsal artery perforator flaps: a clinical experience with 99 patients. Plast Reconstr Surg 2008; 121 (05) 1632-1641
- 28 Chiu ES, Liu PH, Friedlander PL. Supraclavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and outcomes. Plast Reconstr Surg 2009; 124 (01) 115-123
- 29 Kokot N, Mazhar K, Reder LS, Peng GL, Sinha UK. The supraclavicular artery island flap in head and neck reconstruction: applications and limitations. JAMA Otolaryngol Head Neck Surg 2013; 139 (11) 1247-1255
- 30 Nguyen S, Thuot F. Functional outcomes of fasciocutaneous free flap and pectoralis major flap for salvage total laryngectomy. Head Neck 2017; 39 (09) 1797-1805
- 31 Piazza C, Taglietti V, Nicolai P. Reconstructive options after total laryngectomy with subtotal or circumferential hypopharyngectomy and cervical esophagectomy. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (02) 77-88
- 32 Clark JR, Gilbert R, Irish J, Brown D, Neligan P, Gullane PJ. Morbidity after flap reconstruction of hypopharyngeal defects. Laryngoscope 2006; 116 (02) 173-181
- 33 Fujiwara T, Shih HS, Chen CC, Tay SK, Jeng SF, Kuo YR. Interdigitation of the distal anastomosis between tubed fasciocutaneous flap and cervical esophagus for stricture prevention. Laryngoscope 2011; 121 (02) 289-293
- 34 Varvares MA, Cheney ML, Gliklich RE. et al. Use of the radial forearm fasciocutaneous free flap and montgomery salivary bypass tube for pharyngoesophageal reconstruction. Head Neck 2000; 22 (05) 463-468
- 35 Akin I, Torkut A, Ustünsoy E, Taşkoparan G, Gürzumar A. Results of reconstruction with free forearm flap following laryngopharyngo-oesophageal resection. J Laryngol Otol 1997; 111 (01) 48-53
- 36 Endo T, Nakayama Y. Pharyngoesophageal reconstruction: a clinical comparison between free tensor fasciae latae and radial forearm flaps. J Reconstr Microsurg 1997; 13 (02) 93-97
- 37 Nakatsuka T, Harii K, Asato H, Ebihara S, Yoshizumi T, Saikawa M. Comparative evaluation in pharyngo-oesophageal reconstruction: radial forearm flap compared with jejunal flap. A 10-year experience. Scand J Plast Reconstr Surg Hand Surg 1998; 32 (03) 307-310
- 38 Hayden RE, Deschler DG. Lateral thigh free flap for head and neck reconstruction. Laryngoscope 1999; 109 (09) 1490-1494
- 39 Azizzadeh B, Yafai S, Rawnsley JD. et al. Radial forearm free flap pharyngoesophageal reconstruction. Laryngoscope 2001; 111 (05) 807-810
- 40 Baek CH, Kim BS, Son YI, Ha B. Pharyngoesophageal reconstruction with lateral thigh free flap. Head Neck 2002; 24 (11) 975-981
- 41 Scharpf J, Esclamado RM. Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer. Head Neck 2003; 25 (04) 261-266
- 42 Sagar B, Marres HA, Hartman EH. Hypopharyngeal reconstruction with an anterolateral thigh flap after laryngopharyngeal resection: results of a retrospective study on 20 patients. J Plast Reconstr Aesthet Surg 2010; 63 (06) 970-975
- 43 Chen CE, Wu SL, Liao WC, Perng CK, Ma H, Lin CH. Determinants of free fasciocutaneous flap outcomes in partial hypopharyngeal defects. Ann Plast Surg 2019; 82 (1S, Suppl 1): S2-S5
- 44 Bouhadana G, Azzi AJ, Gilardino MS. The ideal flap for reconstruction of circumferential pharyngeal defects: a systematic review and meta-analysis of surgical outcomes. J Plast Reconstr Aesthet Surg 2021; 74 (08) 1779-1790
- 45 Huang TC, Cheng HT. ALT vs. jejunum: have we found the ideal flap for circumferential pharyngoesophageal reconstruction? A meta-analysis of comparative studies. J Plast Reconstr Aesthet Surg 2019; 72 (02) 335-354
- 46 Koh HK, Tan NC, Tan BK, Ooi ASH. Comparison of outcomes of fasciocutaneous free flaps and jejunal free flaps in pharyngolaryngoesophageal reconstruction: a systematic review and meta-analysis. Ann Plast Surg 2019; 82 (06) 646-652
- 47 Tan NC, Lin PY, Kuo PJ. et al. An objective comparison regarding rate of fistula and stricture among anterolateral thigh, radial forearm, and jejunal free tissue transfers in circumferential pharyngo-esophageal reconstruction. Microsurgery 2015; 35 (05) 345-349
- 48 Moody L, Hunter C, Nazerali R, Lee GK. The use of the sternocleidomastoid flap helps reduce complications after free jejunal flap reconstructions in total laryngectomy and cervical esophagectomy defects. Ann Plast Surg 2016; 76 (Suppl. 03) S209-S212
- 49 Moradi P, Glass GE, Atherton DD. et al. Reconstruction of pharyngolaryngectomy defects using the jejunal free flap: a 10-year experience from a single reconstructive center. Plast Reconstr Surg 2010; 126 (06) 1960-1966
- 50 Chan YW, Ng RW, Liu LH, Chung HP, Wei WI. Reconstruction of circumferential pharyngeal defects after tumour resection: reference or preference. J Plast Reconstr Aesthet Surg 2011; 64 (08) 1022-1028
- 51 Yu P, Lewin JS, Reece GP, Robb GL. Comparison of clinical and functional outcomes and hospital costs following pharyngoesophageal reconstruction with the anterolateral thigh free flap versus the jejunal flap. Plast Reconstr Surg 2006; 117 (03) 968-974
- 52 Lewin JS, Barringer DA, May AH. et al. Functional outcomes after circumferential pharyngoesophageal reconstruction. Laryngoscope 2005; 115 (07) 1266-1271
- 53 Morrissey AT, O'Connell DA, Garg S, Seikaly H, Harris JR. Radial forearm versus anterolateral thigh free flaps for laryngopharyngectomy defects: prospective, randomized trial. J Otolaryngol Head Neck Surg 2010; 39 (04) 448-453
- 54 Reiter M, Baumeister P. Reconstruction of laryngopharyngectomy defects: Comparison between the supraclavicular artery island flap, the radial forearm flap, and the anterolateral thigh flap. Microsurgery 2019; 39 (04) 310-315
- 55 Yu P, Robb GL. Pharyngoesophageal reconstruction with the anterolateral thigh flap: a clinical and functional outcomes study. Plast Reconstr Surg 2005; 116 (07) 1845-1855
- 56 Laurell G, Kraepelien T, Mavroidis P. et al. Stricture of the proximal esophagus in head and neck carcinoma patients after radiotherapy. Cancer 2003; 97 (07) 1693-1700
- 57 Colbert SD, Mitchell DA, Brennan PA. Woody hardness - a novel classification for the radiotherapy-treated neck. Br J Oral Maxillofac Surg 2015; 53 (04) 380-383
- 58 Djabali EJ, Rotter J, Chheda NN. et al. Woody hardness classification impact on salvage laryngectomy functional outcomes. Am J Otolaryngol 2021; 42 (03) 102877
- 59 Timmermans AJ, Lansaat L, Theunissen EAR, Hamming-Vrieze O, Hilgers FJM, van den Brekel MWM. Predictive factors for pharyngocutaneous fistulization after total laryngectomy. Ann Otol Rhinol Laryngol 2014; 123 (03) 153-161
- 60 Zenga J, Goldsmith T, Bunting G, Deschler DG. State of the art: rehabilitation of speech and swallowing after total laryngectomy. Oral Oncol 2018; 86: 38-47
- 61 Stoner PL, Fullerton AL, Freeman AM, Chheda NN, Estores DS. Endoscopic dilation of refractory postlaryngectomy strictures: a case series and literature review. Gastroenterol Res Pract 2019; 2019: 8905615
- 62 López F, Obeso S, Camporro D, Fueyo A, Suárez C, Llorente JL. Outcomes following pharyngolaryngectomy with fasciocutaneous free flap reconstruction and salivary bypass tube. Laryngoscope 2013; 123 (03) 591-596
- 63 Punthakee X, Zaghi S, Nabili V, Knott PD, Blackwell KE. Effects of salivary bypass tubes on fistula and stricture formation. JAMA Facial Plast Surg 2013; 15 (03) 219-225
- 64 Bohlok A, Richet T, Quiriny M. et al. The effect of salivary bypass tube use on the prevention of pharyngo-cutaneous fistulas after total laryngectomy. Eur Arch Otorhinolaryngol 2022; 279 (01) 311-317
- 65 Torrico Román P, García Nogales A, Trinidad Ruíz G. Utility of the Montgomery salivary tubes for preventing pharyngocutaneous fistula in total laryngectomy. Am J Otolaryngol 2020; 41 (04) 102557
- 66 León X, Quer M, Burgués J. Montgomery salivary bypass tube in the reconstruction of the hypopharynx. Cost-benefit study. Ann Otol Rhinol Laryngol 1999; 108 (09) 864-868
- 67 Minni A, Ralli M, Di Cianni S. et al. Montgomery salivary bypass tube in head and neck cancer: the experience of our otolaryngology clinic. Ear Nose Throat J 2022; 101 (07) 463-467
- 68 Wu PI, Szczesniak MM, Maclean J. et al. Endoscopic dilatation improves long-term dysphagia following head and neck cancer therapies: a randomized control trial. Dis Esophagus 2019; 32 (06) doy087
- 69 Marijić B, Grasl S, Grasl MC, Faisal M, Erovic BM, Janik S. Do salivary bypass tubes reduce the risk of pharyngocutaneous fistula after laryngopharyngectomy-a systematic review and meta-analysis. Cancers (Basel) 2021; 13 (11) 2827
- 70 Murray DJ, Gilbert RW, Vesely MJ. et al. Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube. Head Neck 2007; 29 (02) 147-154
- 71 Park JY, Song HY, Kim JH. et al. Benign anastomotic strictures after esophagectomy: long-term effectiveness of balloon dilation and factors affecting recurrence in 155 patients. AJR Am J Roentgenol 2012; 198 (05) 1208-1213
- 72 Desai JP, Moustarah F. Esophageal Stricture. Treasure Island, FL: StatPearls Publishing; 2022. Accessed at: https://www.ncbi.nlm.nih.gov/books/NBK542209/
- 73 Shami VM. Endoscopic management of esophageal strictures. Gastroenterol Hepatol (N Y) 2014; 10 (06) 389-391
- 74 Cox JG, Winter RK, Maslin SC. et al. Balloon or bougie for dilatation of benign esophageal stricture?. Dig Dis Sci 1994; 39 (04) 776-781
- 75 Egan JV, Baron TH, Adler DG. et al; Standards of Practice Committee. Esophageal dilation. Gastrointest Endosc 2006; 63 (06) 755-760
- 76 Lerner MZ, Bourdillon AT, Dai F, Brackett A, Kohli N. Safety considerations for esophageal dilation by anesthetic type: a systematic review. Am J Otolaryngol 2021; 42 (05) 103128
- 77 Sharma VK, Nguyen CC, Crowell MD, Lieberman DA, de Garmo P, Fleischer DE. A national study of cardiopulmonary unplanned events after GI endoscopy. Gastrointest Endosc 2007; 66 (01) 27-34
- 78 Chheda NN. Upper esophageal dysphagia. Surg Clin North Am 2022; 102 (02) 199-207
- 79 Khanna N. How do I dilate a benign esophageal stricture?. Can J Gastroenterol 2006; 20 (03) 153-155
- 80 Hernandez LV, Jacobson JW, Harris MS. Comparison among the perforation rates of Maloney, balloon, and savary dilation of esophageal strictures. Gastrointest Endosc 2000; 51(4 Pt 1):460–462 [Erratum in: Gastrointest Endosc. 2003;58(4):642]
- 81 Maejima R, Iijima K, Koike T. et al. Endoscopic balloon dilatation for pharyngo-upper esophageal stricture after treatment of head and neck cancer. Dig Endosc 2015; 27 (03) 310-316
- 82 McLean GK, LeVeen RF. Shear stress in the performance of esophageal dilation: comparison of balloon dilation and bougienage. Radiology 1989; 172 (3 Pt 2): 983-986
- 83 Starck E, Paolucci V, Herzer M, Crummy AB. Esophageal stenosis: treatment with balloon catheters. Radiology 1984; 153 (03) 637-640
- 84 Whitworth PW, Richardson RL, Larson GM. Balloon dilatation of anastomotic strictures. Arch Surg 1988; 123 (06) 759-762
- 85 Zhang T, Szczesniak M, Maclean J. et al. Biomechanics of pharyngeal deglutitive function following total laryngectomy. Otolaryngol Head Neck Surg 2016; 155 (02) 295-302
- 86 Harris RL, Grundy A, Odutoye T. Radiologically guided balloon dilatation of neopharyngeal strictures following total laryngectomy and pharyngolaryngectomy: 21 years' experience. J Laryngol Otol 2010; 124 (02) 175-179
- 87 Liu D, Pickering T, Kokot N, Crookes P, Sinha UK, Swanson MS. Outcomes of combined antegrade-retrograde dilations for radiation-induced esophageal strictures in head and neck cancer patients. Dysphagia 2021; 36 (06) 1040-1047
- 88 Goguen LA, Norris CM, Jaklitsch MT. et al. Combined antegrade and retrograde esophageal dilation for head and neck cancer-related complete esophageal stenosis. Laryngoscope 2010; 120 (02) 261-266
- 89 Kochman ML, McClave SA, Boyce HW. The refractory and the recurrent esophageal stricture: a definition. Gastrointest Endosc 2005; 62 (03) 474-475
- 90 Mendelson AH, Small AJ, Agarwalla A, Scott FI, Kochman ML. Esophageal anastomotic strictures: outcomes of endoscopic dilation, risk of recurrence and refractory stenosis, and effect of foreign body removal. Clin Gastroenterol Hepatol 2015; 13 (02) 263-271.e1
- 91 Annino Jr DJ, Goguen LA. Mitomycin C for the treatment of pharyngoesophageal stricture after total laryngopharyngectomy and microvascular free tissue reconstruction. Laryngoscope 2003; 113 (09) 1499-1502
- 92 Thomas T, Abrams KR, Subramanian V, Mannath J, Ragunath K. Esophageal stents for benign refractory strictures: a meta-analysis. Endoscopy 2011; 43 (05) 386-393
- 93 Fuccio L, Hassan C, Frazzoni L, Miglio R, Repici A. Clinical outcomes following stent placement in refractory benign esophageal stricture: a systematic review and meta-analysis. Endoscopy 2016; 48 (02) 141-148
- 94 Farlow JL, Rosko AJ, Spector ME. Treatment of end-stage pharyngeal strictures after laryngectomy with fasciocutaneous microvascular reconstruction. Oral Oncol 2020; 103: 104556
- 95 Carnevale C, Pagán-Pomar A, Bianchi A, Sarría-Echegaray P, Morales-Olavarría C, Til-Pérez G. Right colonic interposition for severe pharyngoesophageal stricture in head and neck patients: a feasible rescue strategy after multiple failed reconstructive options. Oral Oncol 2021; 121: 105481