A Case of Second-staged Reconstruction using Hinge Flap Preservating Swallowing Function after Failure of forearm free flap reconstruction

For the extirpation of hypopharyngeal carcinoma, in most cases laryngopharyngectomy is indicated because many case of that demonstrate advanced stages. However, in case of localized tumor, partial laryngopharyngectomy can be performed to preserve the laryngeal function. The authors have experienced a case of second-staged reconstruction using hinge flap after failure of forearm free flap reconstruction. The swallowing and phonatory function has preservated with this method. A 51-year-old male was diagnosed to have hypopharyngeal carcinoma of the right pyrif orm sinus (T1N2bM0) and underwent partial laryngopharyngectomy, bilateral neck dissection, and reconstruction of hypopharynx using a free forearm flap. However, necrosis of free flap occurred, we had to perform extirpation of total necrotic flap. To control infections and avoid further complications, we chose the second-staged reconstruction, and at first we performed pharyngeal-cutaneous f istulaplasty. After that, we reconstructed using hinge flap and deltopectoral flap. After all, his laryngeal function (swallowing and phonation) has preserved.