Complex reconstruction technique applied in advanced head and neck cancer.

Area of Science:

• Surgical Oncology
• Reconstructive Surgery
• Head and Neck Cancer Treatment

Background:

• Advanced head and neck cancer (HNC) often results in large defects post-tumor resection, posing significant reconstructive challenges.
• Previous therapeutic methods may fail, necessitating complex salvage surgery for advanced HNC patients.
• Effective reconstruction is crucial for functional and aesthetic outcomes in HNC patients.

Purpose of the Study:

• To evaluate a novel complex reconstruction technique for advanced head and neck cancer (HNC) patients undergoing salvage surgery.
• To assess the feasibility and outcomes of combining anterolateral thigh free flap, fascia lata flap, and greater saphenous vein graft.
• To report the surgical experience and results in managing large defects after tumor excision in advanced HNC.

Main Methods:

• A combination of anterolateral thigh free flap, fascia lata flap, and greater saphenous vein graft was utilized for reconstruction.
• Seven patients with advanced HNC and failed prior therapies underwent tumor excision and this complex reconstruction.
• Flap size ranged from 20x13 cm to 30x15 cm, with vein grafts from 4-11 cm.

Main Results:

• All flaps demonstrated viability post-surgery.
• One patient experienced oral flap edge infection and necrosis requiring debridement.
• Hospitalization ranged from 7 to 33 days, with primary closure of all donor sites.

Conclusions:

• This complex reconstructive approach using combined flaps and grafts is a viable option for advanced HNC patients requiring salvage surgery.
• The technique successfully addressed large defects, with generally good flap survival.
• Further investigation may be warranted to optimize outcomes and minimize complications in complex head and neck reconstructions.