Reconstructive procedures on the denervated gullet.

Abstract

The loss of function of the vagus nerve resulting from radical tumor surgery may require some sort of pharyngeal rehabilitation. This may be accomplished by excision of the denervated muscularis as in partial pharyngectomy. This allows the remainder of the newly formed gullet to be innervated, with 80% to 90% of the innervation provided by the vagus nerve of the contralateral side. Extramucosal myotomy, temporary tracheostomy, and a bypass nasogastric feeding tube are required. However, nasal regurgitation may occur in velopharyngeal insufficiency. A technique is described by using two nasopharyngeal local flaps to narrow the velopharyngeal entrance on the paralyzed side.