scholarly journals Parachute Technique for Head and Neck Free-Flap Inset

2021 ◽  
Vol 64 (9) ◽  
pp. 684-686
Author(s):  
Se Hyun Yeou ◽  
Yong Jae Song ◽  
Ju Ho Lee ◽  
Yoo Seob Shin
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Multimodality Treatment ◽  
Pharyngeal Muscle ◽  
Floor Of Mouth ◽  
Ablative Surgery ◽  
Significant Area ◽  
Surgical Field ◽  
Narrow Space

The treatment outcome of advanced squamous cell carcinoma involving the head and neck is well known to be dire and usually needs multimodality treatment even including optimal reconstruction after ablative surgery. When a significant area of the soft tissue is resected, reconstruction of oral cavity or pharynx needs to minimize morbidities while achieving adequate functional outcomes. For the better functional outcome, invasive approaching procedures such as lip and jaw splitting, or extensive floor of mouth or pharyngeal muscle ablation should be avoided. Without these surgical procedures, reconstructive surgeons may encounter technical difficulties in flap inset due to deep and narrow space after head and neck cancer resection. In a deep and narrow surgical defect, accurate approximation and suture is extremely difficult. Eventually, repeated flap manipulation and stretch might be inevitable, and even pedicle kinking or injury could happen. Herein, we suggested the “parachute” technique, which was generally used in blood vessels or aortic valve suturing in a narrow surgical field and for avoiding mismatched suture. We applied this “parachute” technique for free-flap inset to head and neck defect, and we herein report our successful outcomes.

Preliminary Functional Outcomes and Quality of Life after Tongue Reconstruction with the Vastus Lateralis Myofascial Free Flap

2021 ◽  
Author(s):  
Armando De Virgilio ◽  
Andrea Costantino ◽  
Raul Pellini ◽  
Gerardo Petruzzi ◽  
Giuseppe Mercante ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Vastus Lateralis ◽  
Life Questionnaire ◽  
Donor Area ◽  
Tongue Reconstruction ◽  
Eortc Qlq

AbstractThe aim of the present study is to report our preliminary experience with the vastus lateralis myofascial free flap (VLMFF) for tongue reconstruction according to tongue and donor site functional outcomes. Twelve consecutive patients (F: 5; median age: 54.0 years, interquartile range or IQR 42.75–69.0) were included. The validated European Organization for Research and Treatment of Cancer of the Head and Neck 35 Quality of Life Questionnaire (EORTC QLQ-H&N35) and the performance status scale for head and neck cancer (PSS-HN) questionnaires were used to assess the health-related quality of life (HRQOL). The lower extremity functional scale (LEFS) was used to self-report the donor area function. All patients were successfully treated, and no VLMFF failure was detected during a median follow-up period of 10.5 months (IQR: 6.5–33.0). The HRQOL showed a median EORTC QLQ-H&N35 score of 56.0 (IQR: 50.0–72.5). The median PSS-HN score was 80.0 (IQR: 45.0–95.0), 75.0 (IQR: 62.5–100.0), 75.0 (IQR: 62.5–100.0) for “Normalcy of Diet,” “Public Eating,” and “Understandability of Speech,” respectively. The self-reported function of the lower extremities (donor area) showed a median LEFS of 59.0 (IQR: 32.5–74.0). This study reports optimistic data regarding the functional and quality of life outcomes after tongue reconstruction using VLMFF. Prospective controlled studies are needed to demonstrate advantages and disadvantages when compared with other reconstructive techniques.

Functional outcomes following secondary free flap reconstruction of the head and neck

2009 ◽  
Vol 119 (5) ◽  
pp. 856-860 ◽  
Author(s):  
Tim A. Iseli ◽  
Joshua C. Yelverton ◽  
Claire E. Iseli ◽  
William R. Carroll ◽  
J. Scott Magnuson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines

2016 ◽  
Vol 130 (S2) ◽  
pp. S191-S197 ◽  
Author(s):  
M Ragbir ◽  
J S Brown ◽  
H Mehanna
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Pharyngocutaneous Fistula ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Tissue Transfer ◽  
First Choice ◽  
Ablative Surgery

AbstractThis is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The reconstructive needs following ablative surgery for head and neck cancer are unique and require close attention to both form and function. The vast experience accrued with microvascular reconstructive surgery has meant a significant expansion in the options available. This paper discusses the options for reconstruction available following ablative surgery for head and neck cancer and offers recommendations for reconstruction in the various settings.Recommendations• Microsurgical free flap reconstruction should be the primary reconstructive option for most defects of the head and neck that need tissue transfer. (R)• Free flaps should be offered as first choice of reconstruction for all patients needing circumferential pharyngoesophageal reconstruction. (R)• Free flap reconstruction should be offered for patients with class III or higher defects of the maxilla. (R)• Composite free tissue transfer should be offered as first choice to all patients needing mandibular reconstruction. (R)• Patients undergoing salvage total laryngectomy should be offered vascularised flap reconstruction to reduce pharyngocutaneous fistula rates. (R)

A Method of Closure after Resection of Anterior Floor of Mouth Cancers

1988 ◽  
Vol 99 (3) ◽  
pp. 315-320 ◽  
Author(s):  
Mark C. Weissler ◽  
Manning M. Goldsmith ◽  
Stan Martinkosky
Keyword(s):  
Head And Neck ◽  
Speech Intelligibility ◽  
Functional Results ◽  
Floor Of Mouth ◽  
Ablative Surgery ◽  
Reconstructive Techniques ◽  
Oral Diet ◽  
Marginal Mandibulectomy

A variety of methods may be used to reconstruct head and neck defects after ablative surgery for cancer. Increasingly, choices of reconstructive techniques must be made on the basis of functional results attained. Described is a method of reconstruction for anterior floor of mouth defects with marginal mandibulectomy, which has yielded good functional results. All patients undergoing this form of reconstruction are on a soft oral diet, without drooling and with good speech intelligibility.

Ablative surgery and free flap reconstruction for elderly patients with oral or oropharyngeal cancer: Oncologic and functional outcomes

2011 ◽  
Vol 131 (10) ◽  
pp. 1104-1109 ◽  
Author(s):  
Eric Edi Martial Nao ◽  
Olivier Dassonville ◽  
Gilles Poissonnet ◽  
Emmanuel Chamorey ◽  
Cédric-Sandy Pierre ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Free Flap ◽  
Oropharyngeal Cancer ◽  
Functional Outcomes ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Ablative Surgery

scholarly journals Flap Failure and Salvage in Head and Neck Reconstruction

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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