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Stepladder reconstructive options in post-ablative complex surgical defects in the head and neck.

Hamdy H El Marakby¹, Sherif F Naguib, Abd El-Hamid F El-Sawy

¹The Departments of Surgical Oncology, National Cancer Institute, Cairo University.

Journal of the Egyptian National Cancer Institute

|April 29, 2010

Summary

This study evaluated reconstructive options for head and neck defects, finding satisfactory results in 60% of cases. Flap loss impacted outcomes, highlighting the importance of technique selection in oncologic reconstruction.

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Area of Science:

Plastic Surgery
Head and Neck Surgery
Oncologic Reconstruction

Background:

Head and neck reconstruction presents significant challenges for surgeons.
Key goals include optimizing cosmetic and functional outcomes while ensuring oncologic safety.
Preserving donor site integrity and function is crucial.

Purpose of the Study:

To assess various reconstructive techniques for complex head and neck defects post-malignancy resection.
To evaluate the efficacy of the reconstructive ladder, from local flaps to free flaps.

Main Methods:

A retrospective review of 50 patients with complex head and neck defects.
Procedures were performed at the National Cancer Institute between July 2003 and December 2007.
Reconstructive options included local flaps, skin grafts, pedicled flaps, and free flaps.

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Main Results:

The study included patients with squamous cell carcinoma (74%) and basal cell carcinoma (20%).
Common defect sites were the oral cavity (40%) and hypopharynx (20%).
Local flaps/skin grafts (36%), pedicled flaps (32%), and free flaps (32%) were utilized. Complications occurred in 32% of patients, with 6% total flap loss and 4% partial flap loss. Satisfactory functional and aesthetic results were achieved in 60% of cases.

Conclusions:

The choice of reconstructive method significantly influences outcomes in head and neck cancer surgery.
Flap loss is associated with poorer functional and aesthetic results.
Careful consideration of reconstructive options is vital for successful head and neck defect repair.