Clinical experience with flap reconstruction of post tumor excision head & neck defects

Abstract

Introduction: Soft tissue reconstruction of defects after excision of head & neck malignancies is one of the difficult tasks for plastic surgeons and it has always been a challenge for plastic surgeons to seek options which are safe & with less morbidity and good functional and aesthetic outcomes.¹ Multiple options are available for reconstruction purpose, ranging from simpler options in the form of primary closure and skin grafting, to more complex reconstruction with flaps. Flap coverage is more reliable over simpler options, in terms of functional and aesthetic outcome for the management of head and neck malignancies.² Objectives: The purpose of this study is to determine the role of different types of flaps for the soft tissue reconstruction in the management of head and neck malignancies, and reliability of local flap coverage in the management of head and neck malignancies. Material and Methods:…  Study Design: Retrospective case series. Setting: This study was conducted at the department of Plastic and Reconstructive Surgery, Shaikh Zayed Postgraduate Medical Institute, Lahore. Period: 5 years from 2009 to 2013. Subject and Methods: A total of 63 patients, with diagnosis of head and malignancies, were studied retrospectively over a period of 5 years from June 2009 to June 2013. Age ranged from 18 to 80 years (mean: 59.17 years). There were 30 males (47.61%) and 33 females (52.38%). Soft tissue reconstruction was done with different types of local and distant flaps. Results: A total of 65 different types of flaps were done for the reconstruction purpose. Local flaps were done in 42 (68%) cases, regional flaps were done in 15 (23%) cases and in 6 (9%) cases, free tissue transfer was done. In two cases more than one flap were used for reconstruction. Neck dissection was done in 13(21.74%) of the cases. Good results were achieved in all cases with respect to functional and aesthetic outcome. Conclusion: Despite of the intricate anatomy of head and neck region and the challenging reconstruction, flap reconstruction is a reliable option with good functional and aesthetic outcome and most of the soft tissue reconstruction can be achieved with different local flaps, depending on the extent of soft tissue defect.