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Multiple free flaps for head and neck cancer

Most patients with advanced head and neck cancers now undergo microvascular free flap reconstruction. This is mainly as flaps facilitate complete tumour and margin removal by providing reliable wound coverage and better restoration of form and function. However despite this,...

Two for one forearm flaps

There are many and varied free flaps available for reconstructions. Here is a variant on the workhorse radial free forearm flap. The modification involves a longer, narrower flap that can be rotated back on itself to increase the flap width...

Volume changes in hemiglossectomy reconstruction

This paper analyses the volume changes in 10 patients, five of whom had hemiglossectomy reconstruction with a radial forearm free flap, whilst the other five patients had reconstruction with an anterolateral thigh flap. Both groups underwent postoperative radiotherapy. The volume...

Surgical voice restoration after laryngopharyngectomy

Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...

Freestyle facial artery perforator flaps for nasal reconstruction

This is an update from the authors that originally described the freestyle facial artery perforator flap for one stage nasal reconstruction in 2009. They now update with their 10-year experience of freestyle facial artery perforator flaps, accumulating a series of...

Random-pattern skin flaps: part 4 - transposition flaps

In the final part of our series on local skin flaps (see Part 1, Part 2 and Part 3) in ENT, the authors describe the usefulness of the transposition-type flap and highlight some examples. Rotational advancement flap Useful for defects...

Reconstruction after parotid surgery

This is a retrospective study from Naples, Italy. The authors compare patients with benign parotid disease that were reconstructed with three different techniques. In total 224 patients between February 2002 and March 2009 were included; these patients had either formal...

Improving the temporal contour in reconstruction

A feature of the temporalis flap is the sunken contour left behind. This group from Japan present a variation for filling defects for which we would traditionally use a temporalis muscle containing. The laterally based peri-cranial flap they present uses...

Random-pattern skin flaps: part 3 - Z-plasty flaps

In this third (see Part 1 here, Part 2 here and Part 4 here) of four articles outlining, in some detail, the practical steps for some important local skin flaps, Christopher Thompson and Miles Bannister describe the Z-plasty; a very...

Random-pattern skin flaps: part 1 – advancement flaps

In the first of a short series covering random pattern skin flaps and their use in clinical practice (see Part 2 here, Part 3 here and Part 4 here), Christopher Thompson and Miles Bannister describe in some detail their techniques...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...