Near-Total Pharyngeal Reconstruction by ‘Rotary-Door’ Sternohyoid Myocutaneous Flap in the Dog: A Preliminary Report

Closure of the pharyngoesophagus after total laryngectomy or partial pharyngectomy is not a difficult problem in most cases. Primary suture repair of the defect is usually adequate, providing sufficient healthy mucosa is available. When this is not feasible, it may be necessary to mobilize tissue from distant sites. The deltopectoral and various myocutaneous flaps are often chosen for this purpose because of their reliability and versatility. Unfortunately, they necessitate either two-stage surgery or involve excessive bulk, and both methods result in unsightly defects, especially in women. The "rotary-door" sternohyoid myocutaneous flap avoids these drawbacks, while utilizing tissues within the surgical field in a singlestage procedure. Seven mongrel dogs underwent total laryngectomy and partial pharyngectomy. The pharyngeal defect was closed with a rotary-door sternohyoid myocutaneous flap. Three dogs had an uneventful recovery and two developed fistulae that closed spontaneously within three weeks of surgery. The pharyngocutaneous repair was found to be intact on postmortem examination. (Arch Otolaryngol 1985;111:673-676)