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Inicio Acta Otorrinolaringológica Española Free Flap Reconstruction in the Head and Neck. Indications, Technical Aspects an...
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Vol. 65. Issue 1.
Pages 33-42 (January - February 2014)
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Vol. 65. Issue 1.
Pages 33-42 (January - February 2014)
Original Article
Free Flap Reconstruction in the Head and Neck. Indications, Technical Aspects and Outcomes
Reconstrucción de cabeza y cuello mediante colgajos libres microvascularizados. Indicaciones, aspectos técnicos y resultados
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José Luis Llorentea,
Corresponding author
llorentependas@telefonica.net

Corresponding author.
, Fernando Lópeza, Vanessa Suáreza, Ángel Fueyob, Susana Carnerob, Clara Martínb, Victoria Lópezc, Daniel Camporrob, Carlos Suáreza
a Servicio de Otorrinolaringología, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
b Servicio de Cirugía Plástica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
c Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Figures (5)
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Tables (9)
Table 1. Primary Diagnosis in the 236 Patients.
Table 2. Reconstructed Region According to Primary Location of the Region (n=259 Interventions).
Table 3. Tumoral Stage in the 202 Patients Who Presented Tumours at the Time of Surgery.
Table 4. Prior Treatment in the 246 Patients.
Table 5. Cervical Treatment in the 246 Patients.
Table 6. Surgical Interventions Performed (n=254).a
Table 7. Microvascular Free Flaps Used According to the Reconstructed Region (n=259).
Table 8. Receptor Vessels.
Table 9. Complications.
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Abstract
Introduction and objectives

The use of microvascular free flaps (MFF) has become a common method of head and neck reconstruction because of its high success rates and better functional results. We report our experience in reconstructing complex defects with MFF.

Methods

We analysed a series of 246 patients who underwent reconstruction using MFF in our Department from 1991 to 2013.

Results

A total of 259 interventions were performed in 246 patients. The most common reason for surgery was tumour recurrence (46%), followed by primary tumour resection (25%). The hypopharynx (52%) and the craniofacial region (22%) were the most frequently reconstructed sites. The free flaps most commonly used were the radial forearm free flap (41%) and the anterolateral thigh free flap (35%). Overall success and complication rates of 92% and 20% respectively were reported.

Conclusions

The microvascular free flap is a reliable and useful tool for reconstructing complex head and neck defects and continues to be the reconstructive modality of choice for these defects.

Keywords:
Free flaps
Head and neck reconstruction
Hypopharynx reconstruction
Skull base reconstruction
Resumen
Introducción y objetivos

La utilización de colgajos libres microvascularizados (CLM) se ha convertido en un método de reconstrucción frecuente en el área de cabeza y cuello debido a sus elevadas tasas de éxito y a sus mejores resultados funcionales. Presentamos nuestra experiencia en la reconstrucción de defectos complejos con CLM.

Métodos

Se presenta una serie de 246 pacientes que requirieron una reconstrucción con CLM entre 1991 y 2013.

Resultados

Se realizaron 259 intervenciones en 246 pacientes. El motivo más frecuente para la realización de la cirugía fue la presencia de una recidiva tumoral (46%), seguido de la resección primaria del tumour (25%). Las regiones más frecuentemente reconstruidas fueron la hipofaringe (52%) y la región craneofacial (22%). Los CLM más usados fueron el colgajo antebraquial radial (41%) y el anterolateral de muslo (35%). El 92% de los CLM fue un éxito y la tasa de complicaciones fue del 20%.

Conclusiones

La utilización de CLM es un método fiable y útil para la reconstrucción de defectos complejos de cabeza y cuello, y su uso sigue siendo la modalidad reconstructiva de elección en estos casos.

Palabras clave:
Colgajos libres
Reconstrucción de cabeza y cuello
Reconstrucción de la hipofaringe
Reconstrucción de la base de cráneo

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