[Microsurgical fasciocutaneous and musculocutaneous free flaps in head and neck surgery]

Reconstruction of the head and neck continues to pose a significant challenge for reconstructive surgeons. In many cases microsurgical free flaps provide superior functional and aesthetic results with limited donor-site morbidity and are considered as a method of choice. The purpose of this article was to present the experience of our institution with free flaps used for reconstruction of various cutaneous and mucosal defects in the head and neck region.

This is a retrospective study of 9 consecutive patients who received free revascularized soft tissue flaps for reconstruction in the head and neck area. Among flaps performed in this group, there were: 7 radial forarm flaps, 1 anterolateral thigh flap, and 1 rectus abdominis myocutaneous flap.

7 of 9 flaps healed uneventfully. In 2 patients postoperative neck exploration was required due to neck hematoma with signs of compromised venous outflow from flaps. Both flaps were salvaged, however one of them developed partial necrosis. A normal oral diet and an intelligible speech were recovered in all patients.

The use of microsurgical free flaps has proved to be a versatile, reliable and effective method of reconstruction in the head and neck area. Careful postoperative monitoring allows for early detection of flap compromise and appropriate surgical revision which lead to significant improvements in overall success rates.