# Ileal free flap for hypopharynx reconstruction – case series

## TL;DR

This case series explores using ileal free flaps to reconstruct the hypopharynx while preserving the larynx, showing promising results in six patients.

## Contribution

The study introduces the ileal free flap as a novel surgical option for hypopharyngeal reconstruction with larynx preservation.

## Key findings

- The ileal free flap achieved 100% graft survival in six cases.
- Three patients had normal swallowing function post-surgery.
- Two cases with stenosis improved with endoscopic dilation.

## Abstract

Reconstructing the hypopharynx while preserving the larynx poses a complex surgical challenge due to the limited space and the high position of the hypopharynx in the neck. We present our experience with hypopharyngeal reconstruction and larynx preservation using an ileal free flap.

Six consecutive cases were reported (age range 17–75; 2 females). Indications for surgery were tumor excision, postexcision flap failure, postradiation stenosis, caustic ingestion injury, and cervical esophageal perforation. The larynx was preserved in four cases. Graft survival rate was 100 %. Videofluoroscopic swallowing studies conducted at postoperative day 20–80 were normal in three cases. Two cases presented with stenosis but responded well to endoscopic dilations. Unfortunately, the third case expired due to tumor recurrence.

The ileal free flap is a surgical alternative for the reconstruction of the hypopharynx, especially in cases where the larynx is preserved.