Figure 2.

Sixty-year-old patient after reconstruction for a pharyngotracheal fistula after pharyngolaryngectomy and chemoradiotherapy, which was initially treated using a pedicled pectoralis major muscle flap. A second reconstruction was required for persistent TEF (A). After debridement and dissection of the distal esophagus (B) and the proximal pharynx ((C) arrow), reconstruction was planned using a free jejunum segment (D,E) that was anastomosed to the internal mammary vessels. The skin could not be closed and was left for healing by secondary intention (F). A remaining proximal pharyngocutaneous fistula was closed using an epithesis since the patient denied further operations.