A 69-year-old male, heavy drinker and smoker, operated in 1985 for squamous cell carcinoma of the mouth floor and tongue, performing a hemimandibulectomy with radical dissection of the left neck.
In 1996 reconstruction was performed with free iliac crest graft and titanium bar.
In 1999 he underwent a total suprahyoid laryngectomy for a new squamous cell carcinoma of the larynx with left supraclavicular metastasis (T4N1M0).
The closure of the pharyngostoma was performed using a Herrmann dermo-platism-fascial flap.
Subsequently, he received radiotherapy with a 60-bed mat on the surgical bed and bilateral supraclavicular cervical chains.
In July 2006 she had a recurrence of her oral cavity carcinoma, treated surgically with resection of the base stump of the tongue and reconstruction with left pectoral myocutaneous flap.
In November 2006, he was admitted for the appearance of dysphagia, which conditioned him a total incapacity for oral feeding and caused secondary severe malnutrition.
A nasogastric tube was repeatedly tried, without success.
A nasofibroscopy showed an infra-ncheable pharyngoesophageal stricture of unknown appearance.
An oral endoscopy was then requested which showed a fibrous stenotic zone in the pharyngoesophageal junction, associated with significant hair growth in the pharynx, but without skin inversion in previous surgery.
Esophageal stricture was below expectations resulting in the placement of a surgical gastrostomy according to the Witzel technique.
Currently the patient maintains an adequate nutritional status and there are no data of new tumor recurrence.
