Clinical cases of using a supraclavicular flap for closure of a circular defect of the pharynx and cervical esophagus

Defects after laryngopharyngectomies create a complex esthetics and functional problem. In this article, we present clinical cases of using a supraclavicular island flap for closing defects after surgical treatment of neck tumors.

In the 1^st case, a female patient with poorly differentiated squamous-cell carcinoma of the laryngopharynx underwent modified radical neck dissection on the right, laryngopharyngectomy with pharyngeal reconstruction using a fasciocutaneous supraclavicular flap. In the postoperative period, marginal necrosis of the deltopectoral flap developed but it healed by secondary intention. Control X-ray of the esophagus with barium sulfate showed that the pharynx transplant was functioning, anastomosis with the esophagus was consistent.

In the 2^nd case, a male patient with cancer of the vestibular larynx underwent surgical (tracheostomy, laryngectomy, modified radical neck dissection) and radiation treatment. During follow-up monitoring, a parastomal recurrence was detected which was removed with trachea resection, circular resection of  the cervical esophagus, removal of  the  right lobe of  the  thyroid, and combined defect reconstruction using a  fasciocutaneous supraclavicular flap (circular esophageal defect) and a pectoralis major myocutaneous flap. Postoperative period was complications-free. Control X-ray showed transplant patency and anastomosis consistency.

Therefore, the use of a supraclavicular flap is one of possible variants for closure of circular pharyngeal and esophageal defects and an alter-native for free revascularized flaps in cases where they can’t be used.