{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:47:15Z","timestamp":1761007635400,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Anterior cervical discectomy and fusion have become a common intervention for cervical spine stabilization. However, complications can cause life\u2010threatening morbidity. Among them, esophageal perforation is associated with severe morbidity, including dysphagia, malnutrition, and infection with the potential development of mediastinitis. Presentation is variable but often results in chronic morbidity. Herein we examine our experiences in the management of esophageal perforation with microvascular free tissue transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review from January 2013 to September 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single academic tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study comprised all patients (age, 41\u201073 years) undergoing free tissue transfer for the repair of chronic esophageal perforation secondary to anterior cervical discectomy and fusion at an academic tertiary care center. Four patients underwent repair via vastus lateralis myofascial onlay grafting for defects \u22642\u00a0cm in greatest dimension, while 1 patient underwent a fasciocutaneous radial forearm free flap repair of an 11 \u00d7 5\u2013cm defect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Defect location ranged from hypopharynx to cervical esophagus. Mean operative time was 6.2 hours; the average length of stay for all patients was 6.6\u00a0days. Of 5 patients, 1 required additional hardware placement for spine stabilization. All patients underwent gastrostomy tube placement to bypass the surgical site during healing, and all eventually resumed an oral diet postoperatively. Recurrent fistula occurred in 1 of 5 patients. No flap failures were encountered in the study population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vastus lateralis myofascial onlay grafting and fasciocutaneous radial forearm free flap are robust, relatively low\u2010morbidity interventions with a high success rate for definitive repair of chronic esophageal perforation. Repair should be undertaken in concert with a spine surgeon for management of the cervical spine.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2473974x211031472","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T12:11:12Z","timestamp":1626783072000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Free Tissue Transfer for Repair of Chronic Esophageal Perforations"],"prefix":"10.1002","volume":"5","author":[{"given":"Matthew","family":"Helton","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Jackson T. Stephens Spine and Neuroscience Institute University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Reed","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quinn","family":"Dunlap","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. Glenn","family":"Pait","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Jackson T. Stephens Spine and Neuroscience Institute University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jumin","family":"Sunde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emre","family":"Vural","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio Alejandro","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences Little Rock Arkansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.1.SPINE15898"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568216687296"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-3084-y"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.11.015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.03.01"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20180213-06"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3171\/2009.3.SPINE08522"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2011.02.031"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5151.124164"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2007.06.017"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000182309.97403.ca"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20747"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-005-1006-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.08.037"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000000350"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30170"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20747"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100037\u20101608714"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31820f36aa"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010198810000\u201000011"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198167020-00007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.2.144"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.07.151"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28706"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30495"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824f632d"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.11.180"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003\u20104975(92)90320\u20104"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21712"}],"container-title":["OTO Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/2473974X211031472","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/2473974X211031472","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/2473974X211031472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:42:11Z","timestamp":1760971331000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/2473974X211031472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1177\/2473974X211031472"],"URL":"https:\/\/doi.org\/10.1177\/2473974x211031472","archive":["Portico"],"relation":{},"ISSN":["2473-974X","2473-974X"],"issn-type":[{"type":"print","value":"2473-974X"},{"type":"electronic","value":"2473-974X"}],"subject":[],"published":{"date-parts":[[2021,7]]},"article-number":"2473974X211031472"}}