Maneuvers in Regional Flap Use in Reconstruction of Primary Defects in Head and Neck Cancer Patients: Presentation of Three Cases

Abstract

ABSTRACT This case series highlights the advantages in the use of three regional flaps, submental flap, sternocleidomastoid flap and transverse cervical flap in maxillofacial primary defect reconstruction after ablative cancer surgery through presentation of three head and neck cancer patients in whom it was decided to do pedicled flaps rather than free flaps. Aim and objective This article is done in an attempt for encouraging for more introduction of these three flaps in head and neck reconstruction practice, and to encourage more studies be done to describe skin territory of cervical flap. Materials and methods Three patients presented to oral and maxillofacial department, diagnosed as having different kinds of cancer. All were managed according to the evidence-based guideline of head and neck cancer management, including the work up, diagnosis, TNM classification, surgical treatment, adjuvant treatment and follow-up. In all the three cases, regional flaps were used to close the primary defect. For the first patient, transverse cervical flap was used, the sternocleidomastoid flap in the second and submental flap in the third one. Results All flaps were easy to be harvested, in term of time and technique, and successful in term of viability, extension and in achieving the functional and cosmetic aim of reconstruction, with minimum donor site morbidity, all the patient are enjoying good quality of life. Conclusion and recommendations The regional flaps have their place to overcome limitation of free flaps due to the shortage in the armamentarium available in the hospital, especially in low resources regions, or limitations related to patients general condition, in addition, regional flaps are the best option available in case of failed free flap, or when free flap failure is anticipated and avoided. Highlighting the different maneuvers in harvesting and using regional pedicled flaps for further extensions widens the scope of indications and giving the reconstructive surgeon variability of options in reconstruction, obviates the need for special microvascular expertise in free flaps with comparable results and relatively less complication. How to cite this article Aloosi SN. Maneuvers in Regional Flap Use in Reconstruction of Primary Defects in Head and Neck Cancer Patients: Presentation of Three Cases. Int J Head Neck Surg 2014;5(1):48-55.