The main challenge after total laryngopharyngeal and cervical oesophageal resection for laryngopharyngeal carcinoma, is to provide a suitable feeding conduit which improves the quality of life for the patient. Reconstruction with a tubed free forearm flap can solve the feeding problem to some extent, providing a thin and pliable fasciocutaneous conduit that accommodates well with the thin mucosa of the pharynx and oesophagus.
In this study immediate reconstruction of the pharyngo-oesophagus by free forearm flaps is reported in nine patients with advanced laryngopharyngeal and oropharyngeal carcinoma. The vascularization of the flap is very good, thus rendering this flap to be reliable. The average time for the commencement of oral feeding was 16 days. There was one flap failure (11 per cent), due to venous thrombosis which was replaced by a deltopectoral flap. Long term stenosis did not occur because of the two triangles created at the distal end of the flap which were inserted to the opposite triangular defects at the proximal oesophageal stump.
Donor site morbidities were minimal and scarring of the forearm was acceptable for all the patients.