Salvaging Defects: Scalp Flap as a Rescue Approach in Complex Head and Neck Reconstructive Procedure.

Area of Science:

• Head and Neck Surgery
• Oral Oncology
• Reconstructive Surgery

Background:

• Oral cancer is a major global health issue, with surgery as a primary treatment.
• Reconstruction can be challenging due to recurrence, flap failure, or osteoradionecrosis (ORN).
• Salvage options are crucial for complex head and neck defects.

Purpose of the Study:

• To evaluate the efficacy of the scalp flap as a salvage reconstructive option for oral cancer patients.
• To assess functional and contour outcomes in challenging reconstruction scenarios.

Main Methods:

• Retrospective study of 21 male patients undergoing scalp flap reconstruction for oral cancer defects.
• Flaps were planned using Doppler mapping, elevated in the subgaleal plane, and inset.
• Donor sites were managed with split-thickness skin grafts.

Main Results:

• All 21 patients achieved successful reconstruction of various oral subsites.
• The scalp flap provided effective coverage and satisfactory restoration of function and contour.
• Successful reconstructions were noted in cases of prior flap failure, recurrence, and ORN.

Conclusions:

• The scalp flap is a dependable, well-vascularized salvage option for complex oral cancer reconstructions.
• It is particularly valuable in post-radiation and recurrent cases where conventional flaps are not feasible.
• Despite aesthetic considerations, its anatomical and vascular advantages make it a key alternative.