PLASTIC SURGERY TECHNIQUE IN HEAD AND NECK RECONSTRUCTION-DONOR SITE CLOSURE AND SECONDARY REVISION

Abstract Background Collaboration has been shown to be beneficial when we have complex problems and highly specialized groups, such as in head and neck reconstruction. Otolaryngology, plastic surgery, and oral maxillofacial surgeons perform head and neck reconstruction research. While the specialties represent unique backgrounds, the degree of interdisciplinary collaboration and subtopic focus is unknown. We sought to describe the frequency of interinstitutional interdisciplinary collaboration and examine the association of specialty with research subtopics. Methods Oral presentations from 2014 to 2018 focused on head and neck reconstruction or associated principles at the main reconstructive academic meetings in otolaryngology (American Head and Neck Society), plastic surgery (American Society for Reconstructive Microsurgery), and oral maxillofacial surgery (American Association of Oral and Maxillofacial Surgeons) were reviewed. Author specialty and institution data were recorded. All abstracts were assigned a research subtopic, chosen based on identified themes. Subtopic frequencies among the specialties were compared. Results Thirteen of 88 (15%) US institutions participate in interdisciplinary collaboration in head and neck reconstruction research. Of the remaining institutions, 23 (31%) have researchers performing parallel work and not collaborating. Certain research subtopics were more often presented by each specialty, representing differing interests. Conclusion Collaboration among head and neck reconstruction research at the US institutions is low compared with the potential. Specialties focus on different research subtopics, and therefore can benefit from working together.

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Anterolateral thigh free flaps and radial forearm free flaps in head and neck reconstruction: A 20-year analysis from a single institution

Archives of Plastic Surgery ◽

10.5999/aps.2020.01529 ◽

2021 ◽

Vol 48 (1) ◽

pp. 49-54

Author(s):

Simon Yang ◽

Jong Won Hong ◽

In Sik Yoon ◽

Dae Hyun Lew ◽

Tai Suk Roh ◽

...

Keyword(s):

Head And Neck ◽

Donor Site ◽

Free Flaps ◽

Cancer Site ◽

Head And Neck Reconstruction ◽

Single Institution ◽

Reconstruction Surgery ◽

Neck Reconstruction ◽

Anterolateral Thigh ◽

Radial Forearm

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer.Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients’ age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated.Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups.Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

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Scapular Tip Free Flap in Composite Head and Neck Reconstruction

Otolaryngology ◽

10.1177/0194599818791783 ◽

2018 ◽

Vol 160 (1) ◽

pp. 57-62 ◽

Cited By ~ 4

Author(s):

Jeremiah C. Tracy ◽

Bryan Brandon ◽

Samip N. Patel

Keyword(s):

Head And Neck ◽

Free Flap ◽

Average Length ◽

Academic Medical Center ◽

Donor Site ◽

Case Series ◽

Head And Neck Reconstruction ◽

Bony Defect ◽

Neck Reconstruction ◽

Postoperative Hematoma

Objectives To describe the use of the scapular tip free flap (STFF) in the reconstruction of head and neck defects. Study Design Case series with chart review. Setting Academic medical center. Subjects and Methods A review of the electronic medical record was performed of all patients who underwent head and neck reconstructive surgery with STFFs from January 1, 2014, through January 1, 2016. Details regarding the disease, defect reconstructed, and surgical outcomes were quantified. Results Thirty-one consecutive cases were performed at our institution within the period reviewed. The procedures included reconstruction of 5 maxillectomy and 26 mandibulectomy defects. The mean length of mandible reconstructed was 6.8 cm (95% CI, 6.01-7.59; range, 4.0-10.2). Osteotomies were made to contour the scapular bone in 11 cases, including double osteotomies performed in 2 cases. The most common surgical complications were orocutaneous fistula and postoperative hematoma, which occurred in 3 (10%) and 2 (6.5%) of 31 patients, respectively. Conclusion This series describes a large number of STFFs performed in head and neck reconstruction. The average length of bony defect repair can be significantly larger than what was previously described. Performing osteotomies to the STFF allows for application to anterior mandibular defects. The STFF offers a large soft tissue component, a relatively long pedicle, and acceptable donor site morbidity. The STFF is a versatile reconstructive option that should be considered to address composite defects of the head and neck.

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