Microvascular Free Flaps in Head and Neck Reconstruction: Report of 200 Cases and Review of Complications

Urken, Mark L.; Weinberg, Hubert; Buchbinder, Daniel; Moscoso, Juan F.; Lawson, William; Catalano, Peter J.; Biller, Hugh F.

doi:10.1001/archotol.1994.01880300047007

Cited by 373 publications

(179 citation statements)

References 11 publications

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“…3,8,20,[30][31][32] However, the external jugular vein is preferred as the recipient vein in other reports. 6,33 There are some controversies about the selection of recipient veins after neck dissection. In radical or modified radical neck dissections in which the internal jugular vein is sacrificed, the external jugular vein may be the only readily available recipient vessel on the dissected side.…”

Section: Recipient Veinsmentioning

confidence: 99%

Selection of recipient vessels in microsurgical free tissue reconstruction of head and neck defects

Yazar

2007

Microsurgery

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The development of microsurgical techniques has facilitated proper management of extensive head and neck defects and deformities. Bone or soft tissue can be selected to permit reconstruction with functional and aesthetic results. However, for free tissue transfer to be successful, proper selection of recipient vessels is as essential as the many other factors that affect the final result. In this article selection strategies for recipient vessels for osteocutaneous free flaps, soft tissue free flaps, previously dissected and irradiated areas, recurrent and subsequent secondary reconstructions, simultaneous double free flap transfers in reconstruction of extensive composite head and neck defects, and the selection of recipient veins are reviewed in order to provide an algorithm for the selection of recipient vessels for head and neck reconstruction.

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Section: Recipient Veinsmentioning

confidence: 99%

Selection of recipient vessels in microsurgical free tissue reconstruction of head and neck defects

Yazar

2007

Microsurgery

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“…2,4,5,7 For unsalvageable flaps, a second free flap often needs to be performed if the surgeon does not want to abandon the original goals of the reconstruction. 2,[15][16][17] This study focused on patients with venous obstruction whose flaps could not be salvaged by surgical means.…”

Section: Commentmentioning

confidence: 99%

Leech Therapy for Patients With Surgically Unsalvageable Venous Obstruction After Revascularized Free Tissue Transfer

Chepeha¹,

Nussenbaum²,

Bradford³

et al. 2002

Arch Otolaryngol Head Neck Surg

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“…Drawbacks of this flap, however, are the potential for poor donor site appearance and tendon exposure [9]. In addition, the bulk of tissue available is limited, so that for larger soft tissue defects, the subscapular system (scapular and latissimus dorsi) muscular or myocutaneous flaps have become more popular [10]. The subscapular system provides good tissue bulk; however, it cannot usually be raised at the same time as tumor ablation and frequently requires patient repositioning for flap harvest.…”

Section: Discussionmentioning

confidence: 99%

Deep inferior epigastric artery perforated rectus abdominis free flap for head and neck reconstruction

Cappiello

Piazza

Taglietti

et al. 2011

Eur Arch Otorhinolaryngol

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The deep inferior epigastric artery perforated rectus abdominis (DIEAP-ra) free flap is a modification of the classic myocutaneous DIEA free flap in which only fasciocutaneous tissue is harvested based on the paraumbilical perforators of the medial row. The aim of this retrospective study is to describe our experience with this reconstructive technique in head and neck surgery. Between 2004 and 2009, 24 patients affected by oncologic maxillofacial, skull base, oral, and oropharyngeal defects were submitted to reconstruction with DIEAP-ra. After harvesting the DIEAP-ra, the longitudinally split muscular belly was sutured and the anterior rectus sheath closed with a nonabsorbable mattress suture without inlay mesh interposition. Surgical defects encompassed half of the hard palate in ten patients, orbit and part of the cranial vault in one, radical extended parotidectomy in four, subtotal glossectomy in seven, and total glossectomy in two cases. The only complete flap necrosis (4%) developed as a consequence of an orocutaneous fistula and required a second latissimus dorsi free flap. Another case (4%) developed a partial necrosis for oropharyngeal fistula after total glossectomy that healed after transposition of a pedicled myofascial pectoralis major. Two patients (8%) presented a minor salivary fistula that healed by medication alone. No major complication of the donor site was observed. DIEAP-ra is a valid alternative to the DIEA free flap when applied to complex maxillofacial or tongue major defects. Its greatest advantages are the reduced donor site morbidity and a more adjustable thickness of the skin paddle, particularly in females and obese patients.

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Microvascular Free Flaps in Head and Neck Reconstruction: Report of 200 Cases and Review of Complications

Cited by 373 publications

References 11 publications

Selection of recipient vessels in microsurgical free tissue reconstruction of head and neck defects

Selection of recipient vessels in microsurgical free tissue reconstruction of head and neck defects

Leech Therapy for Patients With Surgically Unsalvageable Venous Obstruction After Revascularized Free Tissue Transfer

Deep inferior epigastric artery perforated rectus abdominis free flap for head and neck reconstruction

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