A comparative study of the repair of surgical defects of the hypopharynx with the pedicled thoracoacromial artery perforator and supraclavicular artery island flap
Bibliographic record
Abstract
Background Hypopharyngeal carcinoma often requires extensive surgical resection, making reconstruction challenging.Objectives This study aimed to compare the clinical outcomes of hypopharyngeal defect reconstruction using thoracoacromial artery perforator (TAAP) flaps and supraclavicular artery island flap (SCAIF), to provide guidance for clinical practice.Material and Methods This prospective study included 40 patients with hypopharyngeal carcinoma who underwent surgery at the Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Chongqing Medical University, between October 2021 and April 2023. The patients were randomly assigned to the TAAP and SCAIF groups (n = 20 each). Preoperative Doppler ultrasonography was performed to localize vascular perforators. Postoperative flap survival, complication rates, shoulder function, and scar appearance were compared between the two groups.Results The groups did not differ significantly in terms of intraoperative defect size, flap harvesting area, or intraoperative blood loss (p > 0.05). Pedicle length (p = 0.015) and operation time (p < 0.01) were significantly longer in the TAAP group than in the SCAIF group. No necrosis was observed in the TAAP group, whereas two patients in the SCAIF group experienced partial flap necrosis leading to pharyngocutaneous fistula, which healed after dressing changes. The donor-site complication rate was 0% in the TAAP group and 20% in the SCAIF group (p < 0.05). The TAAP group had significantly lower Shoulder Pain and Disability Index scores one, three, and six months postoperatively than those in the SCAIF group (p < 0.05), indicating better shoulder function and less pain. Additionally, the TAAP group showed superior cosmetic outcomes, with significant differences in Vancouver Scar Scale scores three and six months postoperatively (p < 0.05).Conclusions and Significance The TAAP flap demonstrated significant advantages over the SCAIF in hypopharyngeal reconstruction, including a longer pedicle and better preservation of shoulder function and aesthetic outcomes, despite a longer operative time. The choice of flap should be selected based on patient needs and surgeon experience.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".