A 67-year-old male patient presented with inexorable facial lymphedema.
Two years before she had undergone surgery for supraglottic squamous cell carcinoma.
The patient underwent supraglottic neck dissection bilaterally and radiotherapy.
The pharmacological treatment used was amoxicillin, mannitol, acetazolamide, furosemide and dexamethasone.
The patient developed arterial hypertension, hypotension, hyperglycemia and hyponatremia affecting the patient's hemodynamic status.
Rehabilitation treatment, transcutaneous punctures and hyperbaric chamber were also used, but without success.
When the patient is referred to us, the patient presents a massive facial edema, a large cervical fibrosis, a gastrostomy, impossibility of cleft lip and palate, oxygen transmission of 85%, bilateral bipalpebral edema inompetence
1.
It was decided to perform a myocutaneous deltopectoral partition with the objective of introducing new lymphatic vessels in the cheek and improving its situation.
A right deltopectoral flap was sized, a 6 × 5 cm distal area was deepithelialized and inserted into a subdermal pocket in the cheek.
Direct closure of the defect is performed except for the distal end where the deepithelialized tissue is placed as a free skin graft.
At 72 h she began to hear, to see, improved lip competence and facial volume had decreased.
One week later, the patient developed respiratory distress caused by right basal atelectasis, which progressively worsened.
It is accompanied by atrial fibrillation, hyponatremia and hyperglycemia.
Finally, the patient died 31 days after surgery due to multiple organ failure.
