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Updated: Aug 5, 2026
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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Recovery Phenotypes After Head-and-Neck Reconstructive Surgery: A Prospective Cohort Comparing Free-Flap and
Sonia Roxana Burtic1,2,3, Bogdan Florin Capastraru4, Panche Taskov5
1Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Diseases (Basel, Switzerland)
|July 27, 2026
Summary
Head-and-neck reconstruction recovery is complex, involving physical and psychological aspects. Pedicled flaps showed higher dependence on feeding tubes, highlighting the need for tailored rehabilitation.
Area of Science:
- Head and Neck Surgery
- Reconstructive Surgery
- Oncology
Background:
- Recovery after major head-and-neck reconstruction is multidimensional, encompassing functional, psychological, and quality-of-life outcomes.
- Current reconstructive outcomes research often lacks integrated, multidimensional assessments.
Purpose of the Study:
- To compare six-month clinical, functional, nutritional, psychological, and body-image recovery between microvascular free-flap and regional pedicled-flap reconstructions.
- To identify risk factors for persistent functional and psychosocial impairment following head-and-neck reconstruction.
Main Methods:
- A prospective cohort study of 87 adults undergoing head-and-neck reconstruction (52 microvascular free flaps, 35 regional pedicled flaps).
- Multidimensional assessments at baseline and 6 months included quality of life (SF-36, WHOQOL-BREF), body image, psychological distress (HADS, PHQ-9, GAD-7), and functional outcomes (FOIS, speech, PEG/tracheostomy dependence).
Main Results:
- Both flap types showed moderate improvements in quality of life and body image at 6 months, but social functioning gains were not robust.
- Pedicled flaps were associated with higher percutaneous endoscopic gastrostomy (PEG) dependence and worse functional oral intake scale (FOIS) scores.
- Major complications correlated with poorer psychological outcomes and increased depression rates; pedicled flap use, radiotherapy, major complications, and lower baseline FOIS independently predicted PEG dependence.
Conclusions:
- Head-and-neck reconstruction recovery is heterogeneous, influenced by baseline swallowing, reconstruction technique, radiotherapy, and complications.
- Risk stratification using these factors supports tailored multidisciplinary rehabilitation and early psycho-oncologic screening for improved patient outcomes.
