Jejunal free flap for reconstruction of the hypopharynx

Squamous cell carcinoma of the hypopharynx is an aggressive tumor with a bad prognosis. When the tumor is resected it is necessary to reconstruct the hypopharynx and the esophagus. Today, reconstruction with a jejunal free flap is considered to be the preferred option. We present a series of five patients with squamous cell carcinoma of the hypopharynx operated on at the Department of Otolaryngology in the Rabin Medical Center. All underwent total laryngopharyngectomy and reconstruction with a jejunal free flap. Three patients resumed total enteral nutrition about two weeks post surgery. One patient suffered from a pharyngocutaneous fistula and continued parenteral nutrition via a jejunostomy. One patient suffered from necrosis of the flap, which necessitated its resection. Despite the morbidity which follows surgery of the hypopharynx and despite the low cure rates, a successful reconstruction with jejunal free flap enables the resumption of oral nutrition and improvement in the patients quality of life.