Novel application of a thyroid gland flap in repairing a mucosal defect to prevent pharyngocutaneous fistula following total laryngectomy: a case report.

Background: Resection of pharyngeal or laryngeal tumors often results in mucosal defects. Which may lead to excessive suture line tension and pharyngocutaneous fistula. The incidence of pharyngocutaneous fistula formation after total laryngectomy is relatively common. In order to reduce the tension of the suture line, a variety of flaps were introduced to repair the defect. Every flap has some defects. For example, the free skin flap may require microvascular anastomosis technology and relatively increase the operation time. The pectoralis major or latissimus dorsi skin flap needs to increase the incision outside the neck region. Therefore, it is very important to design the optimal personalized repair method for specific patients. In this case, in order to minimize the trauma and quickly complete defect repairing, we introduced an innovative application of a pedicled regional flap. To the best of our knowledge, the application of thyroid gland flap (TGF) in this case has not been reported. Meanwhile, it also provides a new option for cervical defect repairing. Case Description: In this case report, a 78-year-old male patient complained of "hoarseness for 3 months and dyspnea for 1 week", and was confirmed as having laryngeal squamous cell carcinoma. He underwent total laryngectomy under general anesthesia. After total laryngectomy, the pharyngeal mucosal defect observed was about 2.0 cm × 2.0 cm. Due to the patient's advanced age and relative weakness, a TGF application from the same incision was used to prevent pharyngocutaneous fistula formation following total laryngectomy. The treatment was successful without any associated complications. Conclusions: In conclusion, a TGF application can be used to repair defects in the neck in selectively suitable cases. The TGF preserving the superior pole vessel can be safely used in mucosal decompression after total laryngectomy. 2022 Gland Surgery. All rights reserved.