{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T19:37:15Z","timestamp":1782761835117,"version":"3.54.5"},"reference-count":7,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,4,29]],"date-time":"2014-04-29T00:00:00Z","timestamp":1398729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Salvage laryngectomy after failed organ preservation often has a high complication rate, pharyngocutaneous fistulas being the most common. These fistulas increase morbidity, prolong hospitalization, and potentially delay adjuvant treatment. Fistula rates in the literature range from 3% to 65%. Use of the pectoralis flap to prevent fistula formation has been adopted as a common practice at our institution. A review of our experience using the overlay myofascial showed a higher than desired complication rate. The aim of this study is to assess whether the use of integrated myocutaneous flap results in a lower fistula rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective review of 30 patients followed by a pilot study of 10 patients. All underwent salvage laryngectomy after failed organ preservation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The operation notes of 40 laryngectomy patients were analyzed. The patient\/tumor characteristics, pretreatment, neck dissection, flap type, and fistula rate were documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient sample was 25% female. All patients received prior radiotherapy, but only 37.5% received prior chemoradiation. Neck dissections were performed in 80% of these patients, 76% of the myocutaneous group, and 84% of the myofascial group. Advanced tumor stage was found in 42% of the myofascial group and 52% of the myocutaneous group. Five of the 19 myofascial patients developed a fistula, whereas seven of the 21 myocutaneous patients developed a fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The use of the pectoralis myocutaneous flap (PMCF) in this pilot series did not show a lower rate of fistula; other alternatives should be pursued to decrease this complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 124:1615\u20131617, 2014<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24466","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T02:25:06Z","timestamp":1381544706000},"page":"1615-1617","source":"Crossref","is-referenced-by-count":25,"title":["Fistula rates after salvage laryngectomy: Comparing pectoralis myofascial and myocutaneous flaps"],"prefix":"10.1002","volume":"124","author":[{"given":"Nabeel A.","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology the University of Oklahoma Health Sciences Center Oklahoma City Oklahoma U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus E.","family":"Medina","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology the University of Oklahoma Health Sciences Center Oklahoma City Oklahoma U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Sanclement","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology the University of Oklahoma Health Sciences Center Oklahoma City Oklahoma U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg A.","family":"Krempl","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology the University of Oklahoma Health Sciences Center Oklahoma City Oklahoma U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5540900321"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.03.024"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.132.1.67"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e3180332e39"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20492"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.6.551"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410301010"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.24466","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.24466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T08:39:00Z","timestamp":1696495140000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.24466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,29]]},"references-count":7,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1002\/lary.24466"],"URL":"https:\/\/doi.org\/10.1002\/lary.24466","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,29]]}}}