Temporal Flaps in Head and Neck Reconstructive Surgery: A Systematic Review of Surgical Techniques

AbstractThe temporal region is a great source of vascularized flap, providing extremely variable and versatile options for reconstruction in head and neck surgery. Its popularity has led to the conception of a large variety of different flaps, in terms of contents and design. Temporal flaps are highly pliable and flexible, providing adequate bulk to obliterate dead spaces and improving engraftment, thus facilitating wound healing. The need to access different anatomical compartments, often far from the original flap anatomical site, has led surgeons to develop techniques to enlarge pedicles and bulk, by reverting and splitting flaps' contents, as well as through partial mandibular and zygomatic resection. To further increase versatility, a multilayered combination of different regional tissues and muscle segmentation techniques has been described. Historically, each flap has had its own proponents and opponents, but a pointy review systematizing techniques and comparatively analyzing different flaps was still missing in the literature. The field of use of some flaps has been progressively limited by the increasing relevance of free tissue transfers, which nowadays may provide success rates up to 95% with a constrained morbidity, thus offering an effective alternative, when available. Given the wide range of reconstructive strategies based on temporal flaps, there is still a great debate on nomenclature and surgical techniques. The present study systematizes the topic, classifying regional flaps according to contents and indications. Harvesting techniques are described stepwise and schematically illustrated, thus offering an indispensable tool to the armamentarium of reconstructive surgeons.

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SUPRACLAVICULAR ARTERY FLAP: A SAFE, VERSATILE AND A RELIABLE FLAP A NEW WORKHORSE IN HEAD AND NECK RECONSTRUCTION OUR CLINICAL EXPERIENCE

International Journal of Advanced Research ◽

10.21474/ijar01/12326 ◽

2021 ◽

Vol 9 (01) ◽

pp. 544-550

Author(s):

Mir Mushtaq ◽

◽

Bashir Ahmad Bhat ◽

Taj Din Wani ◽

Shabir Iqbal ◽

...

Keyword(s):

Head And Neck ◽

Donor Site ◽

Graft Loss ◽

Surgical Techniques ◽

Free Tissue Transfer ◽

Functional Results ◽

Donor Site Morbidity ◽

Head And Neck Reconstruction ◽

Wide Range

Background: Anterior cervical contractures of the neck represent a great challenge for plastic and reconstructive surgeons. Necks can be reconstructed with a wide range of surgical techniques. The supraclavicular flap is easy to harvest without the need for free tissue transfer. It provides a relatively large flap for neck resurfacing with tissue very similar to that of the neck. Material and Methods: This study was carried out in the Plastic Surgery Department of GMC Srinagar between November 2015 and October 2019. It involved 50 patients (40 females and 10 males), in whom supraclavicular artery flap was done to reconstruct head and neck. Follow-up period ranged from 2-27 months (average 12.3). Results: The study involved 50 patients. Mean age was 26.5 years (range 57-12 years). Thirty five patients had post-burn neck contractures, five patients had portwine stain face, three had marjolin ulcer, four patients had post traumatic and three had post bear maul defect. We harvested unilateral flaps in all of patients. In thirty five patients the flap was pedicled, three had adipofascial pedicle and twelve were islanded. The size of the reconstructed defect ranged from 23x10 to 14x6, and the size of the flap varied from 16x7cm to 25x11. Mean length was 21.7 cm. We used a partial thickness skin graft for donor site closure in 41 cases and closed primarily in 9 cases. Flap was used to resurface neck in 35 patients, face resurfacing in 10 patients, as intraoral lining in 3 patients. The following complications occurred: hematoma in 3 cases, partial distal necrosis in 2 cases, and donor site graft loss in 3 cases. Follow-up period ranged from 2-27 months Conclusion: The supraclavicular artery island flap is a thin, malleable fasciocutaneous flap that is easily and rapidly harvested, with a reliable pedicle and minimal donor site morbidity. It constitutes an alternative to local flaps, while providing equivalent functional results, and must be an integral part of the head and neck reconstructive surgeons therapeutic armamentarium.

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Reconstructive techniques in head and neck malignancies

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20170945 ◽

2017 ◽

Vol 3 (2) ◽

pp. 239

Author(s):

Shashhidhar K. ◽

Venkatesh Doreyawar ◽

Nabeel Malick ◽

Sandhya N. S. ◽

Preetham H. N. ◽

...

Keyword(s):

Oral Cavity ◽

Head And Neck ◽

Surgical Techniques ◽

Surgical Oncology ◽

Neck Surgery ◽

Tumour Resection ◽

Common Site ◽

Head And Neck Malignancies ◽

Efficient Alternative ◽

The Aesthetic

Background: Head and neck malignancies are of common occurrence in India requiring early diagnosis for effective reconstruction by various surgical techniques. The aim of the present study was to evaluate the pattern of involvement of head and neck malignancies and to evaluate various surgical resection and reconstruction techniques used in the management of head and neck malignancies. Methods: This is a retrospective study carried out in the Department of ENT and Head & Neck Surgery And Surgical Oncology, Karnataka Institute Of Medical Sciences, Hubballi, from July 2015 to December 2016. All patients who underwent surgery for head and neck malignancy were included in our study. Results: Retrospective analysis of our study yielded 36 cases of which 29 patients were male and 7 were female. In our study commonest age group was 6th and 7th decade constituting 55.55%. The most common site involved was oral cavity constituting about 63.88%. The most common sub-site in oral cavity malignancy was found to be anterior 2/3rdof tongue (25%), followed by lip and buccal mucosa each of which constituted 13.88%. Conclusions: In our study oral cavity was the most common site to be involved in head and neck malignancies, of which anterior 2/3rd of tongue is the most common sub-site. Majority of the patients underwent tumour resection with flap reconstruction. Locoregional flaps form an efficient alternative in cases where primary closure is not possible without compromising the aesthetic outcomes.

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A nyaki dissectiók onkológiai hozamának maximalizálása a sebészi morbiditás egyidejű minimalizálása mellett

Orvosi Hetilap ◽

10.1556/650.2016.30570 ◽

2016 ◽

Vol 157 (47) ◽

pp. 1871-1879

Author(s):

István Háromi ◽

Imre Gerlinger ◽

László Lujber ◽

Balázs Bendegúz Lőrincz

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Surgical Techniques ◽

Neck Surgery ◽

Surgical Morbidity ◽

Statistical Comparison ◽

Regional Lymphadenectomy ◽

Treatment Review ◽

Nodal Yield

Cervical regional lymphadenectomy, also known as neck dissection, is a fundamental procedure in head and neck surgery. Its evolution over 110 years resulted in a great deal of confusion in the literature and in clinical practice, due to the heterogenicity in training, classification and surgical techniques, which makes outcomes comparability virtually impossible. The authors aim to clarify this situation in a structured manner, in order to facilitate communication among all specialists involved in multidisciplinary head and neck cancer care. The ultimate goal is to make sure that each and every head and neck cancer patient receives their optimal treatment. Review of the history and literature with statistical comparison of the two mainstraim methods regarding their nodal yield results. The applied surgical technique has a significant impact on nodal yield. An appropriate surgical concept achieves maximum oncologic benefit, minimum surgical morbidity with optimized adjuvant indications. Orv. Hetil., 2016, 157(47), 1871–1879.

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Message

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v35i1.1303 ◽

2020 ◽

Vol 35 (1) ◽

pp. 2

Author(s):

Cecilia Gretchen Navarro-Locsin

Keyword(s):

Head And Neck ◽

Case Reports ◽

Surgical Techniques ◽

Neck Surgery ◽

Editorial Staff ◽

Evidence Base ◽

Interesting Case ◽

Head And Neck Surgery ◽

The Past ◽

Good Reading

Greetings! This year marks the 64th year of the Philippine Society of Otolaryngology-Head and Neck Surgery. It is a defining year, marked by both national and international events that changed and will most likely continue to change medical practice, public health policy, socio-economic concepts and structures. The SARS-coronavirus-2 (COVID-19) pandemic crashed into the first quarter of 2020 unannounced and with great fury. This great unknown served as the impetus for a flurry of research into every aspect of the disease – its origins, biology, clinical course, and treatment. It initiated an unprecedented interest in research, not just among scientists and clinicians, but most especially amongst the general population. But what is RESEARCH? Re-search - to look again at the past with spectacles, to look at the past with new eyes, to look at the present with a microscope, and to look at the far distance with binoculars – all to better see & perhaps to find answers to our questions. Research fuels the evidence base of our understanding of diseases and the principles of our clinical and surgical practice. Our specialty of Otolaryngology, during this time of the pandemic, will be at the forefront of an exciting time for a renewed quest for knowledge. And what better vehicle to transport us into this new and uncharted world than the Philippine Journal of Otolaryngology Head and Neck Surgery? It is a testament to the unparalleled dedication of the editor-in-chief and editorial staff and the enthusiasm of the contributors, that every year the PJOHNS publishes interesting case reports, relevant descriptive and analytical studies, papers on surgical techniques & instrument innovations, and insightful commentaries. The journal is a platform for our questions and hypotheses. The journal is a venue for our discoveries. But most importantly, the journal is a celebration of our passion for Otolaryngology. Good reading to all! Cecilia Gretchen S. Navarro – Locsin, MD President Philippine Society of Otolaryngology – Head and Neck Surgery

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Surgical Techniques in Otolaryngology�Head and Neck Surgery: Laryngeal Surgery

10.5005/jp/books/12102 ◽

2014 ◽

Cited By ~ 1

Author(s):

T Sataloff Robert ◽

Farhad Chowdhury ◽

J Hawkshaw Mary ◽

E Portnoy Joel ◽

Shruti Joglekar

Keyword(s):

Head And Neck ◽

Surgical Techniques ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Laryngeal Surgery

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Microvascular free flaps in head and neck surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215100128634 ◽

1994 ◽

Vol 108 (11) ◽

pp. 962-968 ◽

Cited By ~ 33

Author(s):

Marcelle Macnamara ◽

Sarah Pope ◽

A. Sadler ◽

H. Grant ◽

M. Brough

Keyword(s):

Head And Neck ◽

Free Flap ◽

Neck Region ◽

Free Flaps ◽

Neck Surgery ◽

Flap Failure ◽

Free Flap Surgery ◽

Wide Range ◽

Radial Forearm ◽

Microvascular Free Flap

AbstractThis study is a retrospective review of 60 patients who had microvascular free flap reconstructions in the head and neck region. They were all performed over a 10-year period by a single surgeon. The series includes a wide range of flap types and analyses pre-operative risk factors for flap failure as well as complications and outcome. Smoking and advanced age did not appear to prejudice flap survival but peripheral vascular disease, cardiac disease and alcohol withdrawal were found to increase the likelihood of flap failure. The most frequent complications encountered were thrombosis of one of the anastomosis and haematoma. The most successful flap in terms of survival and function was the fasciocutaneous radial forearm flap. The literature is reviewed in relation to the general principles of microvascular free flap surgery and the results of this series are placed in context.

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Otolaryngology Societies on Popular Social Media Platforms

Otolaryngology Head & Neck Surgery ◽

10.24966/ohns-010x/100059 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Inna A. Husain

Keyword(s):

Social Media ◽

American Academy ◽

Head And Neck ◽

Neck Surgery ◽

The Public ◽

Online Engagement ◽

Wide Range ◽

Facial Plastic ◽

Social Media Platforms ◽

Use Of Social Media

Objective: The objective of this study is to investigate the use of social media, including Twitter, Facebook, Instagram, YouTube, and TikTok amongst otolaryngology societies. Study Design: Online assessment of social media pages and engagement amongst otolaryngology societies. Setting: Otolaryngology societies and their online engagement with the general community as well as those in the field of otolaryngology. Methods: A list of otolaryngology societies affiliated with Combined Otolaryngology Spring Meetings (COSM)and American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNSF) were compiled. Two reviewers independently accessed popular social media platforms for societal accounts and their online engagement. Results: There is a wide range of social media participation amongst societies. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) has the highest numbers of followers on Twitter, Facebook, and Instagram. The highest follower count on Twitter and Facebook was followed by the American Otological Society (AOS). The American Laryngological Association had no social media accounts. On YouTube, The American Head and Neck Society (AHNS) had the highest amount of engagement. Conclusion: Social media usage and a robust online presence can provide patients a source of reliable healthcare information, educational opportunities to residents, and may be used for recruitment. Otolaryngology societies should consider improving their social media presence as a way to educate the public, patients, and future recruits.

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Application of Cardiovascular Surgical Techniques in Head and Neck Surgery

JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY ◽

10.5106/jjshns.4.9 ◽

1994 ◽

Vol 4 (1) ◽

pp. 9-13

Author(s):

Yuichi Kurono

Keyword(s):

Head And Neck ◽

Surgical Techniques ◽

Neck Surgery ◽

Head And Neck Surgery

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Combined application of virtual surgery and 3D printing technology in postoperative reconstruction of head and neck cancers

BMC Surgery ◽

10.1186/s12893-019-0616-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Chao Li ◽

Yongchong Cai ◽

Wei Wang ◽

Yan Sun ◽

Guojun Li ◽

...

Keyword(s):

Head And Neck ◽

Surgical Techniques ◽

Neck Surgery ◽

Vital Role ◽

Head And Neck Surgery ◽

Surgical Reconstruction ◽

Virtual Surgery ◽

Surgical Technology ◽

Formidable Challenge ◽

Complex Anatomy

Abstract Background The complex anatomy of the head and neck creates a formidable challenge for surgical reconstruction. However, good functional reconstruction plays a vital role in the quality of life of patients undergoing head and neck surgery. Precision medical treatment in the field of head and neck surgery can greatly improve the prognosis of patients with head and neck tumors. In order to achieve better shape and function, a variety of modern techniques have been introduced to improve the restoration and reconstruction of head and neck surgical defects. Digital surgical technology has great potential applications in the clinical treatment of head and neck cancer because of its advantages of personalization and accuracy. Case presentation Our department has identified the value of modern digital surgical techniques in the field of head and neck surgery and has explored its utility, including CAD/CAM technology and VR technology. We have achieved good results in the reconstruction of head and neck surgical resection defects. Conclusion In this article, we share five typical cases from the department of head and neck surgery where the reconstruction was performed with the assistance of digital surgical technology.

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Flap Failure and Salvage in Head and Neck Reconstruction

Seminars in Plastic Surgery ◽

10.1055/s-0040-1721766 ◽

2020 ◽

Vol 34 (04) ◽

pp. 314-320

Author(s):

Weitao Wang ◽

Adrian Ong ◽

Aurora G. Vincent ◽

Tom Shokri ◽

Britney Scott ◽

...

Keyword(s):

Head And Neck ◽

Free Flap ◽

Surgical Techniques ◽

Free Tissue Transfer ◽

Head And Neck Reconstruction ◽

Success Rates ◽

Neck Reconstruction ◽

Flap Failure ◽

Ablative Surgery ◽

Reconstructive Option

AbstractWith advanced head and neck ablative surgery comes the challenge to find an ideal reconstructive option that will optimize functional and aesthetic outcomes. Contemporary microvascular reconstructive surgery with free tissue transfer has become the standard for complex head and neck reconstruction. With continued refinements in surgical techniques, larger surgical volumes, and technological advancements, free flap success rates have exceeded 95%. Despite these high success rates, postoperative flap loss is a feared complication requiring the surgeon to be aware of potential options for successful salvage. The purpose of this article is to review free flap failure and ways to optimize surgical salvage in the scenario of flap compromise.

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