Reconstruction of Multiple Defects after Head and Neck Cancer Ablation

Yeo, Chang Ki; Kim, Jeong Kyu; Kim, Jin Soo; Park, June Sik; Lee, Jung Hyung; Cho, Byung Chae

Abstract

BACKGROUND AND OBJECTIVES: The traditional form of reconstruction of multiple defects after head and neck cancer ablation has been the two-combined regional flaps or that of one regional flap and skin graft. Such flaps, however, have functional and aesthetic problems such as donor site morbidity, and post-operative stenosis and fistula.
MATERIALS AND METHODS
We reviewed clinical data of eleven head and neck cancer patients who have been reconstructed with bilobed flaps or gemini flaps after ablation from November 1988 to October 1998. The patients were divided into four groups. Type I flap is bilobed flap consisting of one bed and fused skin, type II flap is gemini flap consisting of one bed and separated skin, type III flap is gemini flap consisting of separated skin and bed, and type IV flap is bilobed flap or gemini flap composed of free bone graft.
RESULTS
The survival rate of bilobed flaps and gemini flaps was 91%. The most common complication was fistula, followed by donor vein thrombosis and total loss of flap.
CONCLUSIONS
The advantages of bilobed flaps and gemini flaps were one-stage operation, and aesthetic effect for reduced bulk of thinned radial free forearm flap, and diminished morbidity of donor site. Bilobed flaps and gemini flaps were also used for salvage operation of the patients who had been treated with concomitant chemo-radiotherapy, or combined chemo-radiotherapy, or radiotherapy alone for malignant tumors of head and neck.