{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:27:08Z","timestamp":1778689628029,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess potential risk factors influencing diet outcomes after reconstruction of subtotal hypopharyngeal defects using free patch\u2010 or tube\u2010shaped anterolateral thigh (ALT) fasciocutaneous flaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>First\u2010level referral hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2011 and December 2020, we studied hypopharyngeal cancer patients who underwent the reconstruction of hypopharyngeal defects using free patch\u2010 or tube\u2010shaped ALT fasciocutaneous flaps. The choice between patch\u2010 or tube\u2010shaped ALT flaps depended on the defect's nature, favoring patch\u2010shaped for subtotal defects and tube\u2010shaped for circumferential defects. A restricted diet was characterized by a history of enterostomy or endoscopic esophageal dilation treatment postreconstruction. We analyzed patients with restricted diets at 1\u2010 and 3\u2010year follow\u2010up visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010eight patients were enrolled; 39 patch\u2010shaped flaps, and 59 tube\u2010shaped flaps. No significances were noted in demographics, postoperative radiotherapy (RT) or chemotherapy, rates of free flap reoperation\/salvage, or complications. However, a significant difference emerged in diet outcomes at the 1\u2010year follow\u2010up (<jats:italic>P<\/jats:italic>\u2009=\u2009.005). The rate of a restricted diet was 6.08 times higher in patients with tube\u2010shaped flaps compared to patch\u2010shaped flaps (95% confidence interval [CI]: 1.95\u201018.94). Stratifying based on postoperative RT revealed a 5.47 times higher rate of a restricted diet in tube\u2010shaped flap recipients compared to patch\u2010shaped flap recipients (95% CI: 1.44\u201020.48). No significances were observed in 5\u2010year survival rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Concerning postoperative RT, patch\u2010shaped flaps exhibited a lower incidence of a restricted diet compared to tube\u2010shaped flaps. Preservation of the posterior mucosa may play a crucial role in preventing RT\u2010induced esophageal stricture.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.792","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T09:43:37Z","timestamp":1714124617000},"page":"387-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diet Outcome in Patients With Hypopharyngeal Defects Repaired With Different Reconstruction Flaps: A Comparative Study"],"prefix":"10.1002","volume":"171","author":[{"given":"Pin\u2010Keng","family":"Shih","sequence":"first","affiliation":[{"name":"School of Medicine China Medical University Taichung Taiwan"},{"name":"Department of Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian\u2010Xun","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine China Medical University Taichung Taiwan"},{"name":"Department of Surgery China Medical University Hospital Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane D.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery University of Washington Medical Center Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei\u2010Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine China Medical University Taichung Taiwan"},{"name":"Management Office for Health Data China Medical University Hospital Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ti\u2010Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Medicine China Medical University Taichung Taiwan"},{"name":"Department of Radiation Oncology China Medical University Hospital Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih\u2010Chi","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Medicine China Medical University Taichung Taiwan"},{"name":"Trauma and Emergency Center China Medical University Hospital Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-6519(09)70311-5"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2017.00906"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318225832a"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21016"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30406"},{"key":"e_1_2_10_7_1","first-page":"318","article-title":"Reconstruction of large pharyngeal defects with microvascular free flaps and 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