Lattissimus dorsi myocutaneous flap in head and neck surgery

Latissimus dorsi flap was the first myocutaneous flap reported in the literature. Tansini published in 1906 his experience in breast reconstruction. Quillen in 1978 used it as a pedicled flap for the first time in the head and neck region. Our study presents how to use this technique in head and neck reconstructive surgery. The purpose of this report is to show functional and aesthetic results and to report complications with our patients.

We performed a retrospective review of the clinical charts of 30 consecutive patients with various cancers admitted to the Institute of Oncology in Havana, Cuba between September 1998 and August 2002 and who underwent latissimus dorsi myocutaneous flap (LDMF) reconstruction. We focus our report on functional and aesthetic results and postoperative complications.

Tissue coverage was provided for eight large defects of the skin and soft tissues of the neck, ten hypopharyngoesophageal resections, eight oral cavity resections including two with full thickness loss of the cheek, two large parotid skin defects and two orbitomaxillary defects. Complete flap necrosis was present in three cases, all with hypopharyngoesophageal reconstructions. Partial necrosis occurred in two cases.

LDMF is a reliable method in head and neck reconstruction. Because of its exposed pedicle it is more likely to necrose after local infection and fistula in hypopharyngoesophageal reconstructions.