Combination of Modified Free Anterolateral Thigh Skin-Fascia Flap and Pedicled Thoracoacromial Artery Perforator Flap for Entire Circumferential Pharyngoesophageal Defect and External Neck Skin Defect Reconstructions

Simultaneous reconstructions of entire circumference pharyngoesophageal defect and external neck skin defect are challenges for head and neck surgeons. A 57-year old man, who underwent radical tumor resection, suffered with an advanced metachronous second primary esophageal squamous cell carcinoma (SPESCC). Our modified operative technique (mALT-TAAP), a combination of modified free anterolateral thigh (ALT) flap (a fasciocutaneous flap with an extension of fascia) and pedicled thoracoacromial artery perforator (TAAP) flap, was utilized to reconstruct the entire circumference of pharyngoesophageal and external neck skin defect reconstructions. The modified ALT flap, TAAP flap and donor wounds recovered well postoperatively. No morbidity of the donor site or operation-related complication was observed. The postoperative recovery of swallowing function was satisfactory. Our mALT-TAAP reconstruction method could be a decent option for simultaneous reconstructions of entire circumference of pharyngoesophageal defect and external neck skin defect.