Reconstruction of Total Laryngectomy Defect Using Parascapular Free Flap: Case Series

ABSTRACT Background Reconstruction of total laryngectomy defects with vascularized tissue helps minimize the risk of pharyngocutaneous fistula development. Few studies have assessed outcomes following reconstruction with a parascapular free flap. Methods We identified 28 patients who underwent laryngectomy with parascapular free flap reconstruction between 2020 and 2024. Chart review was directed toward operative characteristics and postoperative outcomes, which were summarized using descriptive statistics. Results Thirteen out of 28 patients (46%) underwent salvage laryngectomy. Average operative time was 6.6 (±1.2) hours. Donor site morbidity was low; one patient experienced delayed wound dehiscence that was managed conservatively. Six patients developed pharyngocutaneous fistula; one patient required surgical intervention. The length of hospital stay ranged from 5 to 22 days, and the duration of postoperative nil per os status ranged from 7 to 56 days. Conclusions Our experience demonstrates that the parascapular free flap is a viable option for reconstruction of defects secondary to laryngectomy.