Coverage in head and neck malignancies; our institutional experience

Abstract

Background: Cancer of the head and neck can have a major impact on patients. It is vitally important that the surgeon appreciate the anatomy of the head and neck, the varieties of tumours and their metastatic patterns of spread, the ablative techniques, the adjunctive treatments, and the potential need for reconstruction. The obvious advantages to immediate reconstruction of a defect after ablation of a tumor have been recognized for more than 3 decades and are still valid today.Methods: Those patients who required reconstructive management were included in the study. The patients with head and neck malignancy were operated in association with ENT surgeon’s team or Onco-surgery team. Reconstruction of the defect was done by Plastic Surgeons.Results: In this series various types of reconstructive methods ranging from Split thickness skin graft, full thickness skin graft, fasciocutaneous flaps, fascial flaps, muscle flaps and musculo-cutaneous flaps were used. The defects were primarily sutured in 11% patients. The defects were covered with split thickness skin graft in 6.6% patients. Full thickness skin graft was used in 8.8% patients. Local flaps were used in 6.6% and loco regional flaps were used in 60% for coverage of head and neck defects. Free flaps were used in 6.6% of patients.Conclusions: The study concluded that for management of such defects local flaps were reliable, quick to execute, and capable of covering large defects. It provides skin of excellent colour and texture, and most of the scars are hidden in natural skin folds.