Related Experiment Video
Updated: Apr 30, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Does body mass index matter while selecting the flap type for pharyngeal reconstructions?
Caglar Calli1, Theodoros N Teknos, Amit Agrawal
1From the *Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey; and †Department of Otorhinolaryngology, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio.
Body Mass Index (BMI) influences flap selection for pharyngeal defect reconstruction. Overweight patients show a preference for specific free flaps, suggesting BMI is a key factor in surgical planning.
Area of Science:
- Reconstructive Surgery
- Head and Neck Surgery
- Plastic Surgery
Background:
- Pharyngeal defect reconstruction is crucial for restoring function after surgery or trauma.
- Selection of appropriate flap type is complex, influenced by various patient and surgical factors.
- Understanding the impact of patient-related factors like Body Mass Index (BMI) on flap choice is essential for optimizing outcomes.
Purpose of the Study:
- To investigate the effect of patient-related factors, specifically Body Mass Index (BMI) and tumor size, on the selection of flap types for pharyngeal defect reconstruction.
- To compare the utilization of different free and pedicled flaps in relation to patient BMI and tumor dimensions.
Main Methods:
- Retrospective review of 182 patients undergoing pharyngeal defect reconstruction with free or pedicled flaps.
- Comparison of flap choices based on patient Body Mass Index (BMI) and tumor size.
- Analysis of flap selection trends without functional outcome data (swallowing, speech).
Main Results:
- No statistically significant correlation was found between BMI/tumor size and the choice between free and pedicled flaps (P > 0.05).
- A notable tendency favored radial forearm free flap over anterolateral thigh free flap in overweight and obese patients (32:3 ratio).
- Fibular free flap was preferred over iliac crest free flap in overweight/obese patients (14:5), while the iliac crest flap was preferred in patients with BMI ≤ 24 (3:5).
Conclusions:
- Body Mass Index (BMI) may significantly impact the selection of specific free flap types for pharyngeal defect reconstruction.
- While surgeon experience is paramount, patient BMI should be considered a significant factor in optimizing flap choice.
- Further research incorporating functional outcomes is warranted to fully elucidate the role of BMI in flap selection.
