Forehead Flap for Simultaneous Reconstruction After Head and Neck Malignant Tumor Resection

Area of Science:

• Plastic Surgery
• Head and Neck Oncology
• Reconstructive Surgery

Background:

• Head and neck cancer resection often leads to complex defects requiring single-stage reconstruction.
• Free flap transfer has significantly advanced head and neck reconstruction techniques.
• Forehead flaps, utilizing the superficial temporal artery (STA) or supraorbital/supratrochlear arteries (SOA/STrA), present a novel reconstructive option.

Purpose of the Study:

• To evaluate the efficacy of forehead flaps pedicled with STA or SOA/STrA for head and neck defect reconstruction.
• To assess the functional and aesthetic outcomes of these reconstructive procedures.

Main Methods:

• Forehead flaps were used to reconstruct defects in the hypopharyngeal wall, perioral skin/buccal mucosa, and nasal/periorbital tissues.
• Seventeen male patients underwent reconstruction, with nine using STA-pedicled flaps and eight using SOA/STrA-pedicled flaps.
• Postoperative radiation was administered to 7 patients with STA flaps and 1 patient with SOA/STrA flaps.

Main Results:

• A total of 17 male patients (mean age 61) were treated with a follow-up of 12-180 months.
• Flap sizes up to 10.0 × 6.5 cm (STA) and 9.0 × 7.0 cm (SOA/STrA) were successfully reconstructed.
• No vascular complications, flap necrosis, strictures, or fistulas were observed. All patients maintained optimal function (mouth opening, swallowing) with no local recurrence.

Conclusions:

• Forehead flaps provide thin, pliable tissue with a dependable blood supply, ideal for head and neck reconstruction.
• These flaps exhibit high tolerance to radiotherapy, making them suitable for patients undergoing or requiring radiation.
• Forehead flaps are a valuable, reliable option for selected patients needing simultaneous reconstruction after head and neck cancer surgery.