Flow Chart for Reconstructive Head and Neck Surgery in Composite Soft and Hard Tissue Defects

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Biomedical Engineering

Background:

• Virtual planning is standard for head and neck osseous and composite defect reconstruction.
• Current computational algorithms do not account for soft tissue and vascular pedicle positioning.
• A flowchart is presented to address this limitation in jaw defect reconstruction.

Purpose of the Study:

• To develop and assess a flowchart for virtual planning of soft tissue and vascular pedicle positioning in head and neck reconstructive surgery.
• To enhance existing computational algorithms for hard tissue reconstruction.

Main Methods:

• Screening of clinical records (2013-2018) from a tertiary care center.
• Assessment of a flowchart incorporating soft tissue positioning and vascular pedicle anatomy.
• Evaluation based on defect characteristics and donor site.

Main Results:

• 81 osseous and composite microvascular reconstructive procedures were analyzed.
• Lower jaw defects were most frequent (n=61).
• The free fibula flap was the most utilized reconstructive method, demonstrating versatility.

Conclusions:

• Virtual planning can pre-operatively determine soft tissue and vascular pedicle position.
• The proposed flowchart serves as an enhancement to existing computational algorithms.
• This approach improves the comprehensive virtual planning of complex head and neck reconstructions.