TY - JOUR
T1 - Multiple simultaneous free flaps for head and neck reconstruction
T2 - A multi-institutional cohort
AU - Tharakan, Theresa
AU - Marfowaa, Gifty
AU - Akakpo, Kenneth
AU - Jackson, Ryan
AU - Zenga, Joseph
AU - Puram, Sidharth V.
AU - Pipkorn, Patrik
N1 - Funding Information:
Research by Dr. Tharakan reported in this publication was supported by the National Institute of Deafness and Other Communication Disorders within the National Institutes of Health, through the “Development of Clinician Researchers in Academic ENT” training grant, award number T32DC000022. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/1
Y1 - 2023/1
N2 - Objectives: To describe the experience of two tertiary academic centers with multiple, simultaneous free flaps for complex head and neck defect reconstruction. Methods: Patients undergoing multiple, simultaneous free flaps from 2017 to 2022 were retrospectively reviewed. Results: Seventy-one patients (64.8% male, median age 61 years) were identified and underwent 143 free flaps. The leading surgical indication was squamous cell carcinoma (n = 48, 67.6%). Defect sites included oral cavity, maxilla, pharynx, parotid, skull base, and scalp. The most common free flap combinations were fibula (FFF) with anterolateral thigh flap (n = 33, 46.5%), radial forearm (RFFF) with scapula (n = 11, 15.5%), and RFFF with FFF (n = 10, 14.1%). Median operative time was 12 h. Median length of hospitalization was 10 days. At last follow-up (median 6 months), 141 flaps (98.6%) survived without partial nor complete flap failure. Conclusion: Multiple, simultaneous free flaps are a rare, yet reliable option for head and neck reconstruction in select patients with defects involving several tissue types, multiple functional areas, or large volumes.
AB - Objectives: To describe the experience of two tertiary academic centers with multiple, simultaneous free flaps for complex head and neck defect reconstruction. Methods: Patients undergoing multiple, simultaneous free flaps from 2017 to 2022 were retrospectively reviewed. Results: Seventy-one patients (64.8% male, median age 61 years) were identified and underwent 143 free flaps. The leading surgical indication was squamous cell carcinoma (n = 48, 67.6%). Defect sites included oral cavity, maxilla, pharynx, parotid, skull base, and scalp. The most common free flap combinations were fibula (FFF) with anterolateral thigh flap (n = 33, 46.5%), radial forearm (RFFF) with scapula (n = 11, 15.5%), and RFFF with FFF (n = 10, 14.1%). Median operative time was 12 h. Median length of hospitalization was 10 days. At last follow-up (median 6 months), 141 flaps (98.6%) survived without partial nor complete flap failure. Conclusion: Multiple, simultaneous free flaps are a rare, yet reliable option for head and neck reconstruction in select patients with defects involving several tissue types, multiple functional areas, or large volumes.
KW - Free tissue flaps
KW - Head and neck neoplasms
KW - Mandibular reconstruction
KW - Microsurgery
KW - Mouth neoplasms
UR - http://www.scopus.com/inward/record.url?scp=85142852643&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2022.106269
DO - 10.1016/j.oraloncology.2022.106269
M3 - Article
C2 - 36462329
AN - SCOPUS:85142852643
SN - 1368-8375
VL - 136
JO - Oral Oncology
JF - Oral Oncology
M1 - 106269
ER -