Implants médicaux et chirurgie

Abstrait

Reconstructive Surgery for Patients with Head and Neck Cancer

George Tamvakopoulos

In the last two decades, there have been several changes in the field of head and neck surgery. Reconstructions using microvascular free flaps completely replaced earlier methods. More significantly, there has been a paradigm change toward attempting to re-establish normal function and appearance in addition to reliable wound closure to safeguard key structures. In the current work, an algorithmic method to head and neck reconstruction of various types will be presented. Wherever possible, this approach will be evidence-based. Oncologic head and neck resections frequently produce intricate abnormalities that are difficult to restore. A multipurpose flap with the benefits of both a local flap (i.e., one that is dependable and simple to harvest) and a free flap is urgently needed (thin, pliable with good colour match).

In this work, we evaluated the supraclavicular artery flap’s applicability to head and neck oncologic abnormalities.The transverse supraclavicular artery served as the foundation for the flap, which was employed as a pedicled fasciocutaneous. We evaluated the risks associated with this reconstructive technique as well as its effectiveness.Between 20011 and 2012, 11 instances received supraclavicular artery flaps, 5 of which were male and 6 of which were female. The average flaw measured 5 to 6 cm. nine donor areas had to be mostly closed, and one needed split skin grafting. In a lesion affecting the lateral third of the midrace, we only experienced one full flap loss, which was due to a band of restricting Skin Bridge over the vascular pedicle. Out of 3 patients who underwent augmentation pharyngoplasty following a near total laryngectomy, two patients experienced pharyngeocutaneous fistula (without flap loss). The supra clavicular artery flap is a thin, adaptable, dependable, simple to harvest tissue that can be used to reconstruct head and neck oncologic abnormalities with good cosmetic and functional results at both ends (donor and recipient).