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Haroun F, Benmoussa N, Bouhir S, Alkashnam H, Honart JF. A twostep supraclavicular flap method in head and neck reconstruction for refractory osteoradionecrosis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:218-221. [PMID: 34098167 DOI: 10.1016/j.jormas.2021.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/22/2021] [Accepted: 05/15/2021] [Indexed: 11/18/2022]
Abstract
Techniques of reconstructive surgery of the head and neck region have existed since Antiquity, with the pedicled forehead flap of Susruta as a reference. These methods are constantly evolving, with the introduction of free flaps in the 1980s, and more recently new technologies such as CAD-CAM. However, the surgical management of patients treated by radiotherapy for upper airway cancers remains a challenge in terms of functional and aesthetic results. Indeed, cervical irradiation, which alters the quality of skin and vascular tissue, jeopardizes good healing after head and neck reconstructive surgery. In this article, the authors proposed to revisit the standard technique of the pedicled supraclavicular flap. Flap design inspired from the known and described technique of the two-stage forehead flap, for the management of a fragile patient with refractory mandibular osteoradionecrosis.
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Affiliation(s)
- Fabienne Haroun
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif, F-94805, France
| | - Nadia Benmoussa
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif, F-94805, France.
| | - Samia Bouhir
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif, F-94805, France
| | - Heba Alkashnam
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif, F-94805, France
| | - Jean-François Honart
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif, F-94805, France
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Foy JP, Qassemyar Q, Assouly N, Temam S, Kolb F. [Harvesting technique of chimeric multiple paddles fibular flap for wide oromandibular defects]. ANN CHIR PLAST ESTH 2015; 61:292-7. [PMID: 26497269 DOI: 10.1016/j.anplas.2015.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/07/2015] [Indexed: 10/22/2022]
Abstract
Carcinological head and neck reconstruction still remains a challenge due to the volume and varied tissues needed. Large and wide oromandibular defects require, not just the bone but also soft tissues for the pelvilingual reconstruction and therefore, a second free flap may become necessary in addition to a fibular flap. The option of an unique chimeric flap based on the fibular artery and its branches is less known whereas it offers the advantage of a unique flap with bone, muscle and multiple skin paddles, independent of each other. The aim of this technical note is to present step by step the surgical procedure of this chimeric flap and share this method that avoids a second free flap.
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Affiliation(s)
- J-P Foy
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Département de carcinologie cervicofaciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Q Qassemyar
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Département de carcinologie cervicofaciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
| | - N Assouly
- Département de carcinologie cervicofaciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - S Temam
- Département de carcinologie cervicofaciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - F Kolb
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Département de carcinologie cervicofaciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
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