Restoration of oral competence in double free flap reconstructions of massive lower facial defects with fascia lata slings – Case series and review of the literature

Abstract

Restoration of adequate oral competence is especially challenging in double free flap reconstructions of massive head and neck defects resulting from composite resections. Our report illustrates that oral competence in double free flap reconstructions of extensive oromandibular defects can be successfully restored with tensor fascia lata suspension slings.

Double free flaps in oral cavity and oropharynx reconstruction: Systematic review, indications and limits

“…1). 14 out of the selected 16 articles were case series (only one out of them included less than 10 cases) [4,5,[8][9][10][11][12][13][14][15][16][17][18][19], while the remaining two articles were case reports [20,21]. We tested all of the case series by NICE scoring scale, and 5 out of the 14 articles collected a score ≥6 and were considered as good quality studies; on the other hand, 8 papers scored four or five, and only one paper scored three, as shown in Table 2.…”

Novel technique to prevent or correct open‐mouth deformity after bilateral mandibular resection: Use of tensor fascia lata slings

“…Virtually all of the prior techniques were targeted at soft tissue elevation and suspension in order to prevent gravitational pull on the reconstructed lower lip. Henn et al described restoration of oral competence using a TFL graft to suspend an anterolateral thigh flap used for reconstruction of the lower lip 1 . Similarly, Arem presented a technique for use of a TFL sling to suspend the lip 2 .…”

“…Henn et al described restoration of oral competence using a TFL graft to suspend an anterolateral thigh flap used for reconstruction of the lower lip. 1 Similarly, Arem presented a technique for use of a TFL sling to suspend the lip. 2 In a review of chin-lower lip reconstruction, Dewey et al referenced multiple techniques that utilize tensor fascia lata strips to suspend the lower lip with points of attachment including the periosteum of the zygomatic body, temporalis muscle, masseter muscle, and angle of mouth.…”

Outcomes in Head and Neck Resections That Require Multiple-Flap Reconstructions

“…Twentystudies [9][10][11]13,14,[16][17][18][19][21][22][23][24][25][26][27][28][29][30][31] reportedfunctionaloraestheticoutcomes with a total of 318 patients (eFigure 3 in the Supplement). Of the 250 patients whose postoperative feeding tube dependence was assessed, 62 patients (24.8%) were partially or fully dependent on a feeding tube at the time of follow-up and 188 patients (75.2%) were able to have a fully oral diet (Table 3).…”