PMC8298143_01
CT scan, axial view. There is an abnormal enhancing mass in the left pyriform sinus.
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fig1
The preoperative staging was T3N1M0 based on the American Joint Committee on Cancer (AJCC) TNM system (Figure 1).
The rolled flap was advanced and connected (using modified Gambee suture) to pharyngeal wall to provide additional mucosa to cover the defect.
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fig2
Short arrow indicates anastomosis of flap to oropharynx in proximal. Long arrow indicates anastomosis of rolled flap to cervical esophagus in distal part of the defect.
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fig3
External view of the neck. Flash showing the supraclavicular flap pedicle, demonstrating a viable flap after 2 months of surgery.
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fig4
Flap viability was evaluated using the flap pedicle which was visible and accessible from the anterior aspect of the neck (Figure 4).
Examination of the pharyngeal entrance and supraclavicular flap using fiber-optic, after 2 months of surgery. The long arrow indicates supraclavicular flap and the short arrow indicates new pharyngeal lumen input.
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fig5
After successful initiation of oral feeding, the patient began to receive 30 sessions of adjuvant CRT. 1 year after surgery, no evidence of recurrence was observed (Figure 5).