Reconstructive option of extensive head and neck defects in cancer surgery

Aim of the study was to present the best methods for reconstruction of extensive defects after removal of the head and neck cancer.

Key to success of reconstrucive surgery is choosing an appropriate option that aim at single stage replacement of lost tissue and provide the integrity, function and aesthetic outcome in a perfect balance.

This descriptive study was carried out between march 2009. And march 2013. at the Clinic of Maxillofacial surgery, Clinical center of University of Sarajevo, Bosnia and Herzegovina. A total number of 483 patients with extensive defects were included.

Most of the patients 421 (87%) were males. The diagnosis of squamous cell carcinoma was present in 355 (73.5%) cases wich was statistically significant. Pectoralis major myocutaneous flap was the most common reconstruction method, in 267 (55.3%) cases. Second common method used were local flap 147 (30.4%), then temporal flap 36 (7.5%). Infrahyoid flap, latissimus dorsi, radial forearm free flap and free fibula graft were also used. The prevalence ofpectoralis major myocutaneous flap was statistically significant. The most comon complication among donor and recipient side was hematoma. Total flap necrosis occured in 9 (1.9%) patients. Comparing donor and recipient side in common complications there were no statistical significant difference.

Wich technique for closure to choose depends on the complexity of defect. The pectoralis major myocutaneous flap continues to be the most universal flap in head and neck reconstruction.