Management of an acquired tracheoesophageal fistula with a fascial free flap

BACKGROUND: Failure in the primary repair of a benign acquired tracheoesophageal fistula limits the operative options available at revision. Use of a fascial free flap to treat this condition has not been previously reported. METHODS: We review the case of a patient who had a tracheoesophageal fistula develop after percutaneous tracheostomy, who had failed previous primary repair with strap muscle interposition. RESULTS: A radial forearm fascial free flap was used at revision and resulted in resolution of the fistula. CONCLUSION: Use of a fascial free flap to address a persistent acquired tracheoesophageal fistula, when an accompanying stenotic segment is not present, is a viable treatment option.