Research progress of pedicled flaps for defect repair and reconstruction after head and neck tumor resection_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHEN Jian ,  LI Wei

Department of Head and Neck Surgery, Hubei Cancer Hospital, Wuhan Hubei, 430079, P.R.China;

Corresponding author：

LI Wei, Email: liwei8211@163.com

Keywords：

Pedicled flap; head and neck defects; wound repair

DOI：

10.7507/1002-1892.201710098

Video：

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Objective To summarize the current status of pedicled flaps for defect repair and reconstruction after head and neck tumor resection, and to present its application prospects. Methods Related literature was reviewed, and the role evolution of pedicled flaps in the reconstruction of head and neck defects were discussed. The advance, anatomical basis, indications, advantages, disadvantages, and modification of several frequently used pedicled flaps were summarized. Results The evolution of pedicled flaps application showed a resurgence trend in recent years. Some new pedicled flaps, e.g., submental artery island flap, supraclavicular artery island flap, submandibular gland flap, and facial artery musculomucosal flap, can acquire equivalent or even superior outcome to free flaps in certain cases. Technological modification of some traditional pedicled flaps, e.g., nasolabial flap, pectoralis major myocutaneous flap, latissimus dorsi musculocutaneous flap, temporalis myofascial flap, and temporoparietal fascial flap, can further broaden their indications. These traditional flaps still occupy an irreplaceable role, especially in patients with poor condition and institution with immature microsurgical techniques. Conclusion The pedicled flaps still plays an important role in head and neck reconstruction after tumor resection. In certain cases, they demonstrate some advantages over free flaps, e.g., more convenient harvest, more rapid recovery, less expenditure, and better functional and aesthetic effect.

Citation： CHEN Jian, LI Wei. Research progress of pedicled flaps for defect repair and reconstruction after head and neck tumor resection. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(3): 369-376. doi: 10.7507/1002-1892.201710098 Copy

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1. Lo Nigro C, Denaro N, Merlotti A, et al. Head and neck cancer: improving outcomes with a multidisciplinary approach. Cancer Manag Res, 2017, 9: 363-371.
2. Marur S, Forastiere AA. Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment. Mayo Clin Proc, 2016, 91(3): 386-396.
3. 毛驰, 彭歆, 张雷, 等. 简化的头颈显微重建外科技术及其临床应用. 中国耳鼻咽喉头颈外科, 2016, 23(3): 127-130.
4. Ragbir M, Brown JS, Mehanna H. Reconstructive considerations in head and neck surgical oncology: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol, 2016, 130(S2): S191-S197.
5. Patel SA, Chang EI. Principles and practice of reconstructive surgery for head and neck cancer. Surg Oncol Clin N Am, 2015, 24(3): 473-489.
6. Hanasono MM. Reconstructive surgery for head and neck cancer patients. Adv Med, 2014, 2014: 795483.
7. 李晓明, 宋琦. 头颈肿瘤切除术后重要缺损的特点及修复与重建的原则和策略. 临床耳鼻咽喉头颈外科杂志, 2015, 29(17): 1504-1507.
8. Rigby MH, Hayden RE. Regional flaps: a move to simpler reconstructive options in the head and neck. Curr Opin Otolaryngol Head Neck Surg, 2014, 22(5): 401-406.
9. Patel UA, Hartig GK, Hanasono MM, et al. Locoregional flaps for oral cavity reconstruction: A review of modern options. Otolaryngol Head Neck Surg, 2017, 157(2): 201-209.
10. Martin D, Pascal JF, Baudet J, et al. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg, 1993, 92(5): 867-873.
11. 吴跃煌, 唐平章, 祁永发, 等. 颏下岛状皮瓣应用结果回访. 中华口腔医学杂志, 2002, 37(6): 418-420.
12. 王伯钧, 秦小云, 陆明琛. 带血管蒂颏下皮瓣的应用解剖学. 中华显微外科杂志, 1996, 19(2): 125-127.
13. Schonauer F, Di Martino A, Nele G, et al. Submental flap as an alternative to microsurgical flap in intraoral post-oncological reconstruction in the elderly. Int J Surg, 2016,33 Suppl 1: S51-S56.
14. Howard BE, Nagel TH, Barrs DM, et al. Reconstruction of lateral skull base defects: A comparison of the submental flap to free and regional flaps. Otolaryngol Head Neck Surg, 2016, 154(6): 1014-1018.
15. Lin HC, Huang YS, Chu YH, et al. Vascular anatomy is a determining factor of successful submental flap raising: a retrospective study of 70 clinical cases. PeerJ, 2017, 5: e3606.
16. Aslam-Pervez N, Caldroney SJ, Isaiah A, et al. A retrospective volume matched analysis of the submental artery island pedicled flap as compared to the forearm free flap: Is it a good alternative choice for the reconstruction of defects of the oral cavity and oropharynx? J Oral Maxillofac Surg, 2017.[Epub ahead of print].
17. 肇杨, 项敬周, 刘法昱. 前臂皮瓣、股前外侧穿支皮瓣及颏下岛状皮瓣修复舌癌患者术后生活质量评估. 上海口腔医学, 2017, 26(1): 111-114.
18. Husso A, Suominen S, Acarturk TO, et al. Submental artery flap with sentinel lymph node biopsy in the reconstruction of oral cancer. J Reconstr Microsurg, 2016, 32(2): 153-159.
19. Sittitrai P, Srivanitchapoom C, Reunmakkaew D, et al. Submental island flap reconstruction in oral cavity cancer patients with levelⅠlymph node metastasis. Br J Oral Maxillofac Surg, 2017, 55(3): 251-255.
20. Kramer FJ, Böhrnsen F, Moser N, et al. The submental island flap for the treatment of intraoral tumor-related defects: No effect on recurrence rates. Oral Oncol, 2015, 51(7): 668-673.
21. Rahpeyma A, Khajehahmadi S. A protocol for management of the hairs problem in oral cavity reconstruction by submental flap. J Maxillofac Oral Surg, 2017, 16(1): 108-112.
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