Peroneal flap in hypopharyngeal reconstruction.

BACKGROUND: Hypopharyngeal reconstruction is a complex and challenging task because the goal of the reconstruction is not only defect filling but also restoring functions such as swallowing and speech. In this article, we present a novel approach of using peroneal flaps in hypopharyngeal reconstructions. METHODS: Between 1997 and 2011, 14 peroneal flaps were used to reconstruct the hypopharynx of 13 patients. We retrospectively reviewed all the medical records from those surgeries, searching for either short-term postoperative complications or long-term follow-up morbidity, and researched relevant articles for comparisons with other types of flaps. RESULTS: Of the 14 peroneal flaps, five were applied in tubed form for a circumferential defect. The remaining nine peroneal flaps were applied in the form of a patch for a noncircumferential defect. None of the 14 flaps underwent flap loss. The rates of stenosis and fistula formation were 7.1 and 14.3 %, respectively. The average postoperative hospital stay was 20.2 days. Of 13 patients, nine were able to resume at least a soft diet after the reconstruction. Only one patient remained on nasogastric feeding through the 6-month follow-up period. None of the patients experienced significant complications. CONCLUSIONS: A peroneal flap reconstruction has comparable postoperative complications and donor site morbidity and should be considered as a viable option for hypopharyngeal reconstruction.