الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The treatment paradigm for cancer of the larynx has changed from surgical approaches to laryngeal preservation modalities, including radiotherapy and concurrent chemoradiotherapy. This has led to relegating total laryngectomy to cases with extra laryngeal spread or salvage cases. Salvage total laryngectomy is carried out for residual tumors after finishing treatment, recurrent tumors, or a non-functioning larynx due to radiotherapy or chemoradiotherapy.
It is well established that both local and systemic complications have a higher incidence after a salvage laryngectomy. PCF is the most common and most annoying complication. It increases patient anxiety, morbidity, hospitalization time, and expenses. It also complicates wound healing and delays the start of oral feeding, leading to long-term dependence on feeding tubes. It may rarely cause vascular blowouts by eroding the large vessels of the neck and mediastinum, leading to dangerous outcomes and even death. Fibrosis and endarteritis obliterans caused by radiotherapy and augmented by chemotherapy impair wound healing.
In order to decrease the risk of this complication, vascularized flaps such as the anterolateral thigh free flap and pectoralis major flap have been used as overlay flaps to augment the neopharyngeal closure. Pectoralis major flaps are the most frequent flaps to be utilized for the fulfillment of this purpose. It can be harvested either as a myofacial or a mycutaneous flap.