Free tissue transfer versus pedicled flap reconstruction of head and neck malignancy defects.
AffiliationDepartment of Otolaryngology, Head and Neck Surgery, St James Hospital, Dublin,, Ireland. firstname.lastname@example.org
Carcinoma, Squamous Cell/*surgery
*Free Tissue Flaps
Head and Neck Neoplasms/*surgery
Reconstructive Surgical Procedures/methods
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CitationIr J Med Sci. 2010 Sep;179(3):337-43. Epub 2010 Feb 12.
JournalIrish journal of medical science
AbstractBACKGROUND: With the advent of microsurgery the pedicled flap is considered by many to be an outdated surgical option. AIMS: To explore the relationship between flap survival and pre-morbid risk factors, conduct a comparative analysis of flap and systemic morbidities and complete a cosmesis and functionality assessment for oral and oropharyngeal reconstruction patients. METHODS: 114 patients, over a 13-year period, who had a one-stage reconstructive procedure employing the pectoralis major myocutaneous flap (PMMF) or radial forearm-free flap (RFFF). RESULTS: Variables, including age, smoking and radiation exposure were not statistically significant predictors of flap survival probability. Atelectasis was a significant post-op finding of RFFF patients. Flap dehiscence of >50% was a significant morbidity of PMMF. No statistical difference in cosmetic deformity, diet and socialisation was noted. CONCLUSIONS: Pectoralis major myocutaneous flap remains an enduring and safe flap; however, the RFFF has markedly improved speech performance over the PMMF.
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