Use of split thickness grafts in the repair of excisions of the oropharynx, base of the tongue, and larynx

Abstract

Skin grafts are an important component in immediate reconstruction after extensive resection in the head and neck region. Edgerton [I] has written extensively on their use in the area of the laryngopharynx, and others [2,3] have remarked on their effectiveness in lining the tonsillar area, palate, and tongue. Most of the patients we treat with Tesions in the higher clinical stages have received 6,000 r of cobalt radiation prior to operation. Originally, we were reluctant to use skin grafts in the radiated areas and attempted to draw the structures together for primary closure wherever possible. Patients with carcinoma of the maxilla were an exception to this rule. Part of the repair in these patients for years has been the immediate lining of the defect with a split thickness graft [4]. These grafts usually take well despite high doses of preoperative radiation. Encouraged by this, we began to use skin grafts to cover extensive areas of postradiation resection in the laryngopharynx and oropharynx.