Total parotidectomy defect reconstruction using the buried free flap

Area of Science:

• Head and Neck Surgery
• Plastic and Reconstructive Surgery
• Oncology

Background:

• Total parotidectomy, with or without neck dissection, often results in significant defects requiring reconstruction.
• Traditional reconstruction methods may not always achieve optimal cosmetic results.
• Free tissue transfer presents a potential solution for complex defect reconstruction.

Purpose of the Study:

• To present an alternative method for reconstructing total parotidectomy defects using free tissue transfer.
• To evaluate the cosmetic outcomes of this reconstruction technique.
• To describe the application of free flaps in parotidectomy defect repair.

Main Methods:

• Retrospective review of 18 patients undergoing free flap reconstruction after total parotidectomy (with or without neck dissection) between 2002 and 2009.
• Exclusion of patients with temporal bone or skin resections.
• Evaluation of demographic data, tumor characteristics, surgical details, flap specifics, and adjunctive techniques; patient and physician satisfaction assessed cosmetic results.

Main Results:

• Eighteen patients underwent successful free flap reconstruction, with the anterolateral thigh flap being most common.
• All flaps survived, and patients reported high cosmetic satisfaction, even with adjuvant radiation therapy.
• Adjunctive facial reanimation was used in some cases, demonstrating compatibility with the reconstruction.

Conclusions:

• Free flap reconstruction is a safe and effective method for total parotidectomy defects.
• This technique provides adequate tissue for facial contour restoration, even after extensive surgery and radiation.
• Free flap reconstruction does not impede subsequent facial reanimation procedures.