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Using a Sternocleidomastoid Muscle Flap to Close an Iatrogenic Tracheoesophageal Fistula in a Patient With Advanced Laryngeal Cancer

A Case Report and Literature Review

Chuang, Fu-Chieh, MD; Tung, Kwang-Yi, MD; Huang, Wen-Chen, MD; Yu, Chia-Meng, MD; Yao, Wen-Teng, MD

doi: 10.1097/SAP.0000000000001718
Reconstructive Surgery

Background An iatrogenic tracheoesophageal (TE) fistula is one possible complication after total laryngectomy with flap reconstruction. We used sternocleidomastoid (SCM) rotation flap to close a TE fistula.

Methods and Results A 69-year-old man with laryngeal cancer underwent total laryngectomy with radial forearm free flap reconstruction. A tracheostoma stenosis was noticed 7 months after the tracheostomy tube was removed. The patient underwent tracheostoma dilatation; the iatrogenic TE fistula was noticed 1 month later. We used SCM rotation flap to close the TE fistula. The postoperative course was uneventful. A barium esophagogram showed no leakage in the esophagus.

Conclusions Tracheoesophageal fistula can be reconstructed with an SCM rotation flap. If the TE fistula is of a suitable size, this reconstructive strategy is effective and simple to close persistent TE fistula and avoid further airway complications.

From the Department of Plastic Surgery, Mackay Memorial Hospital, Taipei, Taiwan.

Received September 25, 2018, and accepted for publication, after revision October 3, 2018.

Conflicts of interest and sources of funding: none declared.

Reprints: Fu-Chieh Chuang, MD, Department of Plastic Surgery, Mackay Memorial Hospital, No 92, Sec 2, Zhongshan N Rd, Zhongshan District, Taipei 104, Taiwan, People’s Republic of China. E-mail:

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