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Second osteocutaneous fibular free flaps for head and neck defects
Bobak A Ghaheri1, Jason H Kim, Mark K Wax
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland, Oregon 97239, USA.
The Laryngoscope
|June 4, 2005
Summary
A second fibular osteocutaneous flap harvest is a viable option for head and neck reconstruction when the initial flap fails. Morbidity associated with a second fibular flap is comparable to a unilateral harvest.
Area of Science:
- Microsurgery
- Head and Neck Reconstruction
- Plastic Surgery
Background:
- Fibular free flaps are commonly used for head and neck reconstruction.
- Flap failure necessitates salvage options, potentially including a second flap harvest.
- Data on the morbidity of a second fibular flap harvest are limited.
Purpose of the Study:
- To analyze the morbidity associated with a second fibular free tissue transfer.
- To evaluate the safety and outcomes of repeat fibular flap harvest for head and neck reconstruction.
Main Methods:
- Retrospective analysis of a case series of patients undergoing head and neck free flap reconstruction.
- Identification of patients requiring a second fibular osteocutaneous flap.
- Standardized questionnaire to assess donor site morbidity from the second flap harvest.
Main Results:
- Six patients underwent a second fibular flap harvest due to flap loss, osteoradionecrosis, or tumor recurrence.
- Mean follow-up was 44 months.
- Morbidity from the second harvest was comparable to unilateral harvest, with most patients reporting low to intermediate morbidity; mild cellulitis was the primary donor site complication.
Conclusions:
- Harvesting a second fibular osteocutaneous flap is a reasonable reconstructive choice when a repeat procedure is required.
- The morbidity associated with a second fibular flap harvest is similar to that of a primary unilateral harvest.