Abstract

Supraglottic laryngectomy for laryngeal cancer aims to remove cancer of the larynx whilst preserving its functions of airway protection, breathing and voice production. A well-known long-term complication of this procedure is aspiration. We present a case of a delayed epiglottis reconstruction with auricular free flap for surgical rehabilitation of dysphagia. Primarily the patient underwent supraglottic laryngectomy, bilateral neck dissection and radiotherapy. She had a permanent tracheostoma because of a complete paralysis of the right vocal cord and a residual minimal mobility of the left cord. Her main complaint was leakage of liquid from her tracheostomy whenever she was drinking something. The chondrocutaneous auricular free flap was harvested from the pinna and was based on the superficial temporal artery and accompanying vein. The vessels were anastomosed to the superior thyroid artery and vein via a submandibular neck incision. The neo-epiglottis helped re-establishing a degree of protection of the glottis during deglutition of liquids reducing vocal cords irritation, thereby improving swallowing and voice quality. In conclusion this form of reconstruction should be taken in consideration when surgical rehabilitation of swallowing after supraglottic laryngectomy is indicated.

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