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Trends in head and neck microvascular reconstructive surgery in Liverpool (1992-2001)
J S Brown1, P Magennis, S N Rogers
1Regional Maxillofacial Unit, University Hospital Aintree, Lower Lane, Liverpool, UK. brownjs@doctors.org.uk
The British Journal of Oral & Maxillofacial Surgery
|September 20, 2005
Summary
Head and neck cancer reconstruction evolved with perforator and free style free flaps. This review highlights shifts towards bulkier flaps for tongue resections and increased use of iliac crest flaps.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Oncology
Background:
- Microvascular reconstructive techniques are standard in head and neck surgery.
- The field is advancing with perforator and free style free flaps.
Purpose of the Study:
- To review trends in free flap reconstruction for head and neck cancer over a decade.
- To analyze changes in flap selection and application.
Main Methods:
- Retrospective review of a database from 1992-2002.
- Analysis of 620 free flap reconstructions in 977 patients with malignant disease.
- Categorization of flap types used, including radial forearm, iliac crest, fibular, scapular, and others.
Main Results:
- A total of 620 defects were reconstructed using various free flaps.
- Radial forearm flaps were most common (358), followed by composite radial forearm (78) and iliac crest (84).
- Trends show increased use of bulky flaps for tongue resections and a preference for iliac crest flaps in composite reconstructions.
Conclusions:
- Free flap reconstruction in head and neck cancer has seen significant modification.
- Flap selection has adapted to accommodate larger resections, particularly for the tongue.
- Further research is needed to improve flap monitoring and tissue transfer reliability.