The throat, or the pharynx, is the cavity that communicates the oral cavity and the nasal passages, and ends in the passage to the esophagus and the trachea. Reconstruction of this area is generally required after the removal of malignant tumors or as a result of birth defects such as a cleft palate. Tumors of the pharynx can be the secondary result of primary growths spreading from the tongue or oral cavity.
Reconstruction using local flaps is frequently used to treat birth defects, such as the repair of a cleft palate. Local mucosal flaps from the oral cavity of the necessary size or volume are not available, and it is therefore necessary to make use of regional flaps or free flaps of skin or muscle that are transferred with the blood vessels supplying them, and then attached to blood vessels in the area of the defect using microsurgical techniques.
The local flap that is useful in these cases is the flap of the pectoralis major muscle, which is transferred with a section of attached skin, by way of a subcutaneous channel through the neck. The free flaps that are useful in these cases are taken from the forearm or the front of the thigh. The choice of flap is determined by the size of the defect, the volume of the defect, and the thickness of the flap. It is easier to shape a relatively thin flap to fit a complex defect that requires three-dimensional molding of the structure, such as the wall of the pharynx and the soft palate, or proximal structures, such as the tongue.