Abstract
To date head and neck reconstructions of oncological defects have concentrated on primarily filling the defect to achieve primary wound healing, secondly restore function and lastly cosmesis. This paper describes a refinement of existing free tissue transfer techniques for improvement of contour, function and aesthetics. A retrospective review of 38 patients operated on by one surgeon at St Vincent's, Royal Melbourne and Western Hospitals over a 3-year period was conducted. Data were collected on patient demographics, tumour details, nature of the defect, type of reconstructive procedure, nature of additional tissue used, radiotherapy, complications and outcome. We present refinements in using de-epithelialized skin paddles, flexor hallucis longus, and rectus and vastus lateralis muscle in order to achieve optimal reconstruction. Free tissue transfer refinements are discussed in anterolateral thigh, fibula, rectus and anteromedial thigh free flaps. The average defect size and volume of neck dissection prior to reconstruction is presented. A variation of radical, modified radical and selective neck dissections were required for oncological staging and clearance. Rare and minor associated complications are discussed. Post-operative radiotherapy treatment was used in the majority of patients with preoperative adjuvant therapy required in some salvage cases. All patients achieved primary wound healing post-operatively with no salivary leaks, flap failures or exposure of neck vessels. Supplementary microsurgical tissue transfer of de-epithelialized skin, vastus lateralis, flexor hallucis longus and rectus muscles is a valuable option for restoring contour, aesthetics and vessel protection post-radiotherapy.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.