Immediate Reconstruction of Defects Developed After Treatment of Head and Neck Tumors Using Cutaneous and Composite Flaps

Korean Journal of Head & Neck Oncology 1985;1(1):35-61.
Published online October 30, 1985.

Kwan Chui Tark;Young Ho Lee;Jae Duk Lew

두경부종양 치료 후 발생한 결손의 피판 및 복합조직이식을 이용한 재건

卓寬哲;李英浩;柳在德

Abstract

The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels. We obtained satisfactory results coincided with goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.