Cervicofacial and Cervicothoracic Rotation Flaps: An Update

Abstract

Objective: 1) Understand the indications for use of the cervicofacial and cervicothoracic advancement flaps in head and neck reconstruction. 2) Learn the surgical technique for constructing cervicofacial and cervicothoracic advancement flaps in head and neck reconstruction. 3) Describe the varying defects that can be reconstructed with cervicofacial and cervicothoracic advancement flaps. Method: Retrospective review of medical records at a university-based head and neck cancer center. Patients were operated on between 2001 and 2012. Patients had varying lesions that were amenable to cervicofacial and/or cervicothroacic advancement flaps. After a thorough description of indications and defect locations, complications and flap viability were evaluated. Results: Sixty-nine patients were identified, with a mean age of 66 years. Primary or recurrent skin neoplasms made up the most common surgical indication, followed by primary parotid tumors and cervical metastases from aerodigestive tract malignancies. Defects of the cheek, orbit, periauricular region, and neck were reconstructed with cervicofacial or cervicothoracic flaps. Larger wounds required extension of the incision onto the chest wall. Other reconstructive modalities were used in 38 cases to increase tissue bulk or provide internal lining. Minor wound complications occurred in 15 patients. There was no statistically significant association between wound complications and smoking or previous radiation therapy. Conclusion: Compound cervicofacial and cervicothoracic rotation flaps provide a straightforward, reliable, and efficient means to reconstruct compledefects of the face, lateral skull.