Browsing by Subject "Head and Neck Reconstruction"

Now showing 1 - 9 of 9
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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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    Free Tissue Transfer Flaps in head & Neck Reconstruction: Microvascular Anastomosis Technique
    (2025-10-31) van Zyl, Ottie; Fagan, Johan
    This chapter describes the surgical technique of microvascular anastomosis, and the management of patients undergoing vascularised free tissue transfer reconstruction of the head and neck. Readers are referred to the open access atlas chapters on free flaps listed at the end of this chapter for technical details about how to raise these flaps, and to chapters about their applications to reconstruct floor of mouth, mandibulectomy, partial glossectomy, total glossectomy, total max-illectomy, inferior maxillectomy, oropharyngeal, total laryngectomy and cervical oesophageal defects.
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    Lateral Scapular Border Free Flap for Head and Neck Reconstruction
    (2025-10-31) Amanian, Ameen; M Bur, Andrés
    The lateral scapular border free flap (LSBFF) is a versatile component of the subscapular system, widely utilized in head and neck reconstruction. Harvested as an osseous or osteocutaneous free flap, the LSBFF is based on the circumflex scapular artery (CSA) and may incorporate skin, muscle, and up to 13 cm of bone from the lateral scapular border. The osseous segment, supplied by periosteal perforators from the CSA, allows for multiple osteotomies for reconstructing multi-segment mandibular or midface defects. The flap’s versatility enables chimeric reconstructions, combining scapular or parascapular skin paddles (based on the transverse or descending branches of the CSA, respectively) or including additional tissues such as the latissimus dorsi or serratus anterior musculature supplied by the thoracodorsal artery. The CSA and accompanying circumflex scapular vein (CSV) can be traced to the subscapular artery and vein for increased pedicle length and vessel caliber, facilitating microvascular anastomosis.
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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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    Radial Free Forearm Flap (RFFF): Surgical Technique
    (2025-10-31) van Zyl, Ottie
    The radial free forearm flap (RFFF) was one of the first free tissue transfer flaps to be described. It has since become a work-horse for soft tissue replacement in head and neck cancer surgery, being commonly used to replace external skin and internal mucosal linings. It is an extremely versatile flap allowing intricate folding of the skin, using two or more skin paddles / islands, and incorporating vascularised tendon and/or bone (osteocutaneous flap).
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    Supraclavicular for Head & Neck Reconstruction
    (2025-10-31) Atallah, Marie-Renée; Alfalas, Mohammad; Ayad, Tareck
    The supraclavicular flap is a perforant pedicled fasciocutaneous flap with a reliable axial pattern, based on the supraclavicular artery. It is centered over the shoulder joint, extending from the supraclavicular region up to the lateral surface of the upper arm, overlying the deltoid muscle. It is well suited to restore lining and volume of head and neck defects, while preservinggood function and acceptable cosmetic outcomes. The supraclavicular flap was first described by Lamberty in 197. However, be cause of a high incidence of distal flap necrosis, its use was limited at that time. In 1997, Pallua and Machens described a modification of the flap, which was successfully used to reconstruct eight cases of neck contractures. They later published an atomical studies which helped the flap to regain respectability. Its use and indica tions have increased since then.
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    Ulnar Forearm Free Flap (UFFF): Surgical Technique
    (2025-10-31) Hintze, Justin; Nagel, Thomas; Chang, Brent
    The ulnar forearm free flap (UFFF) is a fasciocutaneous free flap based on the ulnar artery. It was first described by Lovie et al. in 1984. It provides relatively thin tissue from the distal medial forearm. It shares many similarities with the radial forearm free flap (RFFF) but is used much less commonly for head and neck reconstruction.
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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.
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    Vacularised Free Fibular Flaps (FFF) in Head and Neck Reconstruction
    (2025-10-31) van Zyl, Ottie; Fagan, Johan
    The vascularised free fibular flap (FFF) is the most used flap in head and neck for bony reconstruction. It is a vascularised free composite flap containing bone and muscle, with or without skin and provides reliable single-stage reconstruction with excellent functional and aesthetic results. Other vascularised bone flaps used in the head and neck include iliac crest, scapula and radial forearm flaps. Microvascular free tissue transfer allows one to transfer well-vascularised, bone-containing flaps for oromandibular and midface reconstruction. Compared to bone grafts or metal plates, well-vascularised bone is associated with a major reduction of surgical complications and has had an enormous impact on the success of such reconstructions. Vascularised flaps with-stand irradiation much better than bone grafts or plates, and when reconstructing within a previous irradiated field, has the benefit of importing tissue with a new blood supply.