Last updated: 02/17/2009

After undergoing a pharyngectomy, special attention is given to the patient's pulmonary function and fluid/nutritional balance, as well as to local wound conditions in the neck, thorax, and abdomen. Regular postoperative checks of calcium, magnesium,...

and phosphorus levels are necessary; supplementation with calcium, magnesium, and 1,25-dihydroxycholecalciferol is usually required. A patient may be unable to take in enough food to maintain adequate nutrition and experience difficulty eating (dysphagia). Sometimes it may be necessary to have a feeding tube placed through the skin and muscle of the abdomen directly into the stomach to provide extra nutrition. This procedure is called a gastrostomy.

Reconstructive surgery is also required to rebuild the throat after a pharyngectomy in order to help the patient with swallowing after the operation. Reconstructive surgeries represent a great challenge because of the complex properties of the tissues lining the throat and underlying muscle that are so vital to the proper functioning of this region. The primary goal is to re-establish the conduit connecting the oral cavity to the esophagus and thus retaining the continuity of the alimentary tract. Two main techniques are used:

• Myocutaneous flaps. Sometimes a muscle and area of skin may be rotated from an area close to the throat, such as the chest (pectoralis major flap), to reconstruct the throat.
• Free flaps. With the advances of microvascular surgery (sewing together small blood vessels under a microscope), surgeons have many more options to reconstruct the area of the throat affected by a pharyngectomy. Tissues from other areas of the patient's body such as a piece of intestine or a piece of arm muscle can be used to replace parts of the throat.