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Double free-flap reconstruction: indications, challenges, and prospective functional outcomes
Jennifer P Guillemaud1, Hadi Seikaly, David W J Cote
1Division of Otolaryngology-Head and Neck Surgery, University of Alberta Hospital, Room 1E4.29 Walter MacKenzie Health Science Centre, 8440-112 St, Edmonton, AB T6G 2R7, Canada.
Archives of Otolaryngology--Head & Neck Surgery
|April 22, 2009
Summary
Double free flaps effectively reconstruct large head and neck defects, offering good functional outcomes for speech and swallowing. This technique allows for optimal tissue selection without significantly increasing surgery time or complications.
Area of Science:
- Head and Neck Surgery
- Reconstructive Surgery
- Oncology
Background:
- Large head and neck defects pose significant reconstructive challenges.
- Double free flap reconstruction is an emerging technique for complex cases.
Purpose of the Study:
- To investigate the utility and outcomes of double free flaps in head and neck defect reconstruction.
- To analyze functional results, including speech intelligibility and swallowing function.
Main Methods:
- Retrospective review of 35 patients undergoing double free flap reconstruction for head and neck defects.
- Analysis of prospectively collected functional data (speech intelligibility, swallowing studies).
Main Results:
- Squamous cell carcinoma was the most common indication (71.4%).
- Osteocutaneous fibular and fasciocutaneous radial forearm flaps were the most common combination (62.9%).
- Mean single-word intelligibility was 66.2%, and sentence intelligibility was 84.8%; swallowing function was preserved in most patients.
Conclusions:
- Double free flap reconstruction is a viable option for large head and neck defects.
- Proper patient selection and surgical planning are crucial for success.
- This technique allows for optimized tissue selection and achieves satisfactory functional outcomes without increased surgical burden.