Simultaneous Two Free Flaps for Head and Neck Reconstruction

Abstract

The use of the free tissue transfers Improves the functional and cosmetic results of the head and neck reconstruction. Because a large composite defect or bilateral defects can not be reconstructed with a single free flap in one-staged operation, simultaneous double free flaps are used to achieve the reconstructive goals. Iii 1999, five patients of head and neck defects were reconstructed immediately with two free flaps. Four patients of primary buccal cancer and one recurrent tongue cancer were all squamous cell carcinoma The combined free anterolateral thigh flap and free fibular osteocutaneous flap were used for the large through-and- through oromandibular defects after the buccal cancei resection as well as for the oropharyngeal-mandibular defect after the ablation of the recurrent tongue cancer One patient of synchronous bilateral buccal cancers underwent the reconstruction with bilateral free anterolateral thigh flaps. Nine of the 10 flaps survived. One anterolateral thigh flap in the patient of bilateral buccal cancers suffered from venous thrombosis, which had been explored but failed. The radial forearm flap was salvaged and survived well later, Minor complications including one wound infection and one skin graft loss of donor site were noted and healed after debridement and skin graft. The combined anterolateral thigh flap and fibular flap have played an important role in the reconstruction of the oromandibular composite defects.