NS1 - Supraclavicular Artery Island Flap: An Underutilized Option for Reconstruction Following Primary Laryngectomy
SCURS Disciplines
Medicine & Health Sciences
Document Type
General Presentation (Oral)
Invited Presentation Choice
Not Applicable
Abstract
Hypothesis
Supraclavicular artery island flap (SCAIF) reconstruction is a useful option following primary total laryngectomy to support neopharyngeal closure and facilitate containment of pharyngocutaneous fistula should it occur.
Introduction
Pharyngocutaneous fistula (PCF) following total laryngectomy is a frequent complication. Fistulas often form in the immediate peristomal area, making wound care challenging. While free tissue transfer and pectoralis major myocutaneous pedicled flaps are reliable options to decrease leaks and contain fistulas, they add significant operative demands and donor-site morbidity. We describe our experience using an alternative, the SCAIF, to support neopharyngeal closure and simplify fistula management in cases complicated by PCF.
Methods
A retrospective review was performed of patients who underwent primary total laryngectomy with immediate SCAIF reconstruction at a single academic institution between October 2024 and October 2025. Demographics, comorbidities, flap details, and postoperative outcomes were analyzed.
Results
Five patients underwent total laryngectomy with immediate SCAIF reconstruction. In four patients, the flap was used for suprastomal augmentation and in one for neopharyngeal reconstruction. There were no instances of complete or partial flap failure. All patients passed initial postoperative esophagram. Two patients developed delayed pharyngocutaneous fistulas. In both cases, the SCAIF provided tissue separation between the fistula tract and the stoma, allowing effective negative-pressure wound therapy (NPWT). No further operative procedures were required in either case. Donor-site morbidity included shoulder pain (n=4, 80%) and surgical site infection (n=1, 20%). No upper-extremity weakness, contour deformity, or functional limitations were documented.
Conclusions
Our initial experience suggests that the SCAIF is a useful adjuvant following primary laryngectomy with minimal donor-site morbidity and without the need for microsurgical reconstruction. Operative techniques are illustrated through intraoperative photographs.
Start Date
10-4-2026 2:10 PM
Location
CASB 105
End Date
10-4-2026 2:25 PM
NS1 - Supraclavicular Artery Island Flap: An Underutilized Option for Reconstruction Following Primary Laryngectomy
CASB 105
Hypothesis
Supraclavicular artery island flap (SCAIF) reconstruction is a useful option following primary total laryngectomy to support neopharyngeal closure and facilitate containment of pharyngocutaneous fistula should it occur.
Introduction
Pharyngocutaneous fistula (PCF) following total laryngectomy is a frequent complication. Fistulas often form in the immediate peristomal area, making wound care challenging. While free tissue transfer and pectoralis major myocutaneous pedicled flaps are reliable options to decrease leaks and contain fistulas, they add significant operative demands and donor-site morbidity. We describe our experience using an alternative, the SCAIF, to support neopharyngeal closure and simplify fistula management in cases complicated by PCF.
Methods
A retrospective review was performed of patients who underwent primary total laryngectomy with immediate SCAIF reconstruction at a single academic institution between October 2024 and October 2025. Demographics, comorbidities, flap details, and postoperative outcomes were analyzed.
Results
Five patients underwent total laryngectomy with immediate SCAIF reconstruction. In four patients, the flap was used for suprastomal augmentation and in one for neopharyngeal reconstruction. There were no instances of complete or partial flap failure. All patients passed initial postoperative esophagram. Two patients developed delayed pharyngocutaneous fistulas. In both cases, the SCAIF provided tissue separation between the fistula tract and the stoma, allowing effective negative-pressure wound therapy (NPWT). No further operative procedures were required in either case. Donor-site morbidity included shoulder pain (n=4, 80%) and surgical site infection (n=1, 20%). No upper-extremity weakness, contour deformity, or functional limitations were documented.
Conclusions
Our initial experience suggests that the SCAIF is a useful adjuvant following primary laryngectomy with minimal donor-site morbidity and without the need for microsurgical reconstruction. Operative techniques are illustrated through intraoperative photographs.