Browsing by Author "Pipkorn, Patrik"

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    Anterolateral Thigh (ALT) Free Flap for Head and Neck Reconstruction
    (2025-10-31) Pipkorn, Patrik; van Zyl, Ottie
    The Anterolateral Thigh (ALT) flap has gained increased popularity for head and neck reconstruction, mainly due to its minimal donor site morbidity. Although it is a fasciocutaneous flap, it can be harvested with a cuff of vastus lateralis muscle. It is based on perforators of the descending branch of the lateral circumflex femoral artery and can provide large areas of vascularised skin for reconstruction. It can be used for any soft tissue reconstruction including facial skin, oral cavity e.g. partial or total glossectomy, and as semi-tubed or tubed flaps for pharyngeal defects.
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    Latissmus Dorsi Flap for Head and Neck Reconstruction
    (2025-10-31) Pipkorn, Patrik; Jackson, Ryan; Haughey, Bruce
    The flap can be harvested as a pedicled or free flap and as a muscular or myocuta-neous flap with an overlying skin paddle. It can also be harvested along with any other flap based on the subscapular vascular system as a chimeric or subscapular “mega-flap”. Despite its size it can be harvested without significant donor site morbidity. The muscle is normally about 1cm thick. Because it atrophies significantly if it is not reinnervated, it is a popular option for scalp reconstruction and for other defects in the head and neck area including reconstruction of skull base and total glossectomy defects.
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    Paramedian Forehead Flap Nasal Reconstruction Surgical Technique
    (2025-10-31) Cervenka, Brian; Tollefson, Travis; Pipkorn, Patrik
    The paramedian forehead flap is a versatile pedicled flap based on the supratrochlear artery and is commonly used for nasal reconstruction. First described in 700 BC in ancient Indian literature by Sushruta Samita to reconstruct nasal defects from punitive tip amputation, it has subsequently become a workhorse of nasal reconstruction requireing more than 2cm soft tissue replacement on the external and internal nose. The paramedian forehead flap is simple to harvest, causes minimal donor site deformity, provides a large amount of skin and subcutaneous tissue that can be used for coplete external and internal nasal defects, and has a robust vascular supply allowing successful flap inset even when perichondrium or periosteum of the recipient site has been removed or there is poor vascular supply. Drawbacks include that it is a 2-stage procedure, and transfer of hair bearing tissue in patients with a low-lying hairline to the external nose.
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    Rectus Abdominis Flap for Head & Neck Reconstruction
    (2025-10-31) Pipkorn, Patrik; Nussenbaum, Brian
    The rectus abdominis flap is based on the deep inferior epigastric artery. It is a composite flap and comprises muscle, over-lying fascia and skin. It is versatile and provides a large volume of soft tissue and is technically straightforward to raise. Many variations based on the inferior epigastric artery, including perforator flaps, have been described. In the head and neck it is typically used to reconstruct large oral defects, skull base defects, maxillectomy defects or whenever a large volume of soft tissue is required. In the head and neck it has more recently been largely supplanted by the anterolateral thigh free flap.
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    Upper & Lower Trapezius Flaps for Head & Neck Reconstruction
    (2025-10-31) Pipkorn, Patrik; Jackson, Ryan; Rich, Jason
    Trapezius flaps are a useful reconstructive option for the head and neck. Because of the popularity of microvascular surgery, as well as surgeons’ unfamiliarity with back flaps and the need for lateral or prone surgical positioning, trapezius flaps have however decreased in popularity. But, in a setting without microvascular expertise and with other reconstructive options exhausted, these are robust and reliable flaps with low morbidity. There are three types of trapezius flaps i.e. upper, lower and lateral trapezius island flaps. The lateral trapezius island flap has a very variable blood supply and is very seldom used and is not covered in this chapter.