Abstract
Reconstructive surgery of the soft tissue of the head and neck is a challenge for the surgeon owing to the three-dimensional nature of the face and its tissues.
When deciding on a reconstructive technique, the traditional idea that the simplest reconstruction is usually the best should always be taken into account, as long as the basic tenets of functionality and cosmetic requirements are met. Therefore, defects that can be satisfactorily resolved using local or regional flaps should not be reconstructed using microsurgery. However, some patients need greater tissue bulk, which can only be harvested from distant regions, and would therefore benefit from free flap-based reconstruction techniques.
This chapter addresses the microsurgical free flaps most commonly used for reconstruction of the soft tissue of the head and neck. Advantages and disadvantages are presented.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Navarro I, Arias J. Reconstrucciones craneomaxilofaciales complejas (cap 56). In: López Davis A, Martín Granizo R, editors. Cirugía oral y maxilofacial. Madrid: Panamericana; 2012. p. 630–49
Yang G, Chen B, Gao Y, et al. Forearm skin flap transplantation. Natl Med J China. 1981;61:139.
Menick FJ, Salibian A. Microvascular repair of heminasal, subtotal, and total nasal defects with a folded radial forearm flap and a full-thickness forehead flap. Plast Reconstr Surg. 2011;127(2):637–51.
Biglioli F, Liviero F, Frigerio A, Rezzonico A, Brusati R. Function of the sensate free forearm flap after partial glossectomy. J Craniomaxillofac Surg. 2006;34(6):332–9.
Sasidaran R, Zain MA, Basiron NH. Lip and oral commissure reconstruction with the radial forearm flap. Natl J Maxillofac Surg. 2012;3(1):21–4.
Van Cann EM, Koole R. The ulnar forearm free flap for the reconstruction of soft tissue defects in the head and neck area: free flap outcome and donor site outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:851–4.
Antony AK, Hootnick JL, Antony AK. Ulnar forearm free flaps in head and neck reconstruction: systematic review of the literature and a case report. Microsurgery. 2014;34(1):68–75.
Song YG, Chen GZ, Song YL. The free thigh flap: a new free flap concept based on the septocutaneous artery. Br J Plast Surg. 1984;37:149–59.
Huang CH, Chen HC, Huang YL, Mardini S, Feng GM. Comparison of the radial forearm flap and the thinned anterolateral thigh cutaneous flap for reconstruction of tongue defects: an evaluation of donor-site morbidity. Plast Reconstr Surg. 2004;114:1704–10.
Jiang C, Guo F, Li N, Liu W, Su T, Chen X, Zheng L, Jian X. Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck. PLoS One. 2014; 9(9): e106326. doi:10.1371/journal.pone.0106326.
Lakhiani C, Lee MR, Saint-Cyr M. Vascular anatomy of the anterolateral thigh flap: a systematic review. Plast Reconstr Surg. 2012;130(6):1254–68.
Engel H, Huang JJ, Lin CY, Lam W, Kao HK, Gazyakan E, Cheng MH. A strategic approach for tongue reconstruction to achieve predictable and improved functional and aesthetic outcomes. Plast Reconstr Surg. 2010;126(6):1967–77.
Revenaugh PC, Haffey TM, Seth R, Fritz MA. Anterolateral thigh adipofascial flap in mucosal reconstruction. JAMA Facial Plast Surg. 2014;16(6):395–9.
Pennington DG, Pelly AD. The rectus abdominis myocutaneous free flap. Br J Plast Surg. 1980;33(2):277–82.
Brown JS, Shaw RJ. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol. 2010;11:1001–8.
Herr MW, Lin DT. Microvascular free flaps in skull base reconstruction. Adv Otorhinolaryngol. 2013;74:81–91.
López-Arcas JM, Arias J, Morán MJ, Navarro I, Pingarrón L, Chamorro M, Burgueño M. The deep inferior epigastric artery perforator (DIEAP) flap for total glossectomy reconstruction. J Oral Maxillofac Surg. 2012;70(3):740–7.
Watson JS, Craig RD, Orton CI. The free latissimus dorsi myocutaneous flap. Plast Reconstr Surg. 1979;64(3):299–305.
Kim SW, Hwang KT, Kim JD, Kim YH. Reconstruction of postinfected scalp defects using latissimus dorsi perforator and myocutaneous free flaps. J Craniofac Surg. 2012;23(6):1615–9.
Takushima A, Harii K, Asato H, Kurita M, Shiraishi T. Fifteen-year survey of one-stage latissimus dorsi muscle transfer for treatment of longstanding facial paralysis. J Plast Reconstr Aesthet Surg. 2013;66(1):29–36.
Bach CA, Wagner I, Lachiver X, Guth A, Baglin AC, Chabolle F. The free thoracodorsal artery perforator flap in head and neck reconstruction. Eur Ann Otorhinolaryngol Head Neck Dis. 2012;129(3):167–71.
McLean DH, Buncke Jr HJ. Autotransplant of omentum to a large scalp defect, with microsurgical revascularization. Plast Reconstr Surg. 1972;49(3):268–74.
Ramzisham AR, Somasundaram S, Nasir ZM, Ali F, Das S. Successful free omental flap and skin graft reconstruction of scalp avulsion injury. Clin Ter. 2010;161(5):453–5.
Song R, Song Y, Yu Y, et al. The upper arm free flap. Clin Plast Surg. 1982;9:27–35.
Thankappan K, Kuriakose MA, Chatni SS, Sharan R, Trivedi NP, Vijayaraghavan S, Sharma M, Iyer S. Lateral arm free flap for oral tongue reconstruction: an analysis of surgical details, morbidity, and functional and aesthetic outcome. Ann Plast Surg. 2011;66:261–6.
Cavadas PC, Sanz-Giménez-Rico JR, Gutierrez-de la Cámara A. The medial sural artery perforator free flap. Plast Reconstr Surg. 2001;108:1609–15.
He Y, Jin SF, Zhang ZY, Feng SQ, Zhang CP, Zhang YX. A prospective study of medial sural artery perforator flap with computed tomographic angiography-aided design in tongue reconstruction. J Oral Maxillofac Surg. 2014;72(11):2351–65.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Navarro Cuellar, I., González Otero, T., Ruiz Cruz, J.A., Navarro Vila, C. (2015). Reconstruction of Soft Tissue Defects Using Microsurgical Flaps. In: Navarro Vila, C. (eds) Reconstructive Oral and Maxillofacial Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20487-1_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-20487-1_4
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-20486-4
Online ISBN: 978-3-319-20487-1
eBook Packages: MedicineMedicine (R0)