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Reconstructive head and neck surgery


Okayama Igakkai Zasshi 95(5-6): 395-404
Reconstructive head and neck surgery
Various surgery techniques performed on 26 advanced cancer patients using forehead, deltopectoral (D-P) and musculocutaneous (M-C) flaps were reviewed. The D-P flap presents few cosmetic problems in the head and neck region and can be used in elderly patients because of little operative invasion. The M-C flap allows for reconstruction of defects in a 1-stage operation which may shorten hospitalization and permit an earlier return to social life. The forehead flap is the most durable and reliable flap for reconstructive surgery, though it offers some cosmetic problems. In reconstruction of the esophagus after a pharyngolaryngoesophagectomy for cancer of the hypopharynx and the cervical esophagus, it seems more advantageous to use a hinge flap in reconstruction than Bakamjian's original method since early detection of a local recurrence of the tumor is rendered easier with the former. There were not fatal postoperative complications, though minor necrosis, fistula, suture insufficiency and esophageal stenosis were observed, but they improved with conservative treatment. Consequently, the reliability and versatility of pedicle and muculocutaneous flaps were confirmed. The 2-yr survival rate was 42.2%. The cause of death was local recurrence in 4 patients, who all died within 2 yr, and distant metastasis in 4 patients, who all died within 1 yr of the operation. Local recurrence and distant metastasis were also seen in 4 patients who survived.

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Accession: 006273287



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