Case of total glosso-laryngectomy without reconstructive surgery for perioperative cardiac arrest

Free tissue grafting or pediculate musculocutaneous flap reconstruction is usually required after total glosso-laryngectomy. We performed total glosso-laryngectomy and bilateral neck dissection for a base of tongue cancer T4aN2cM0 case. However, reconstructive surgery became impossible due to sudden perioperative cardiac arrest. Therefore sutures were performed only in left pharyngeal mucosa and a fistula was formed to thereby form the oral floor and the pharynx. Only skin was present under the suture mucosa. Postoperatively, hyperplasy of the granulation and epithelization due to the mucosa displayed deterioration, and the oral floor was formed. Ingestion of a liquid diet was shown to be possible by videofluorography performed on day 50 after an operation. The patient was discharged on day 77 after an operation without showing a recurrence by postoperative 2-month MRI/CT. Even if reconstruction became impossible, this experience demonstrates that troubleshooting was possible by available wound closure after total glosso-laryngectomy.