Strategies for Avoiding Complications with Vascularized Bone Flaps in Head and Neck Microvascular Reconstruction
Identifieur interne : 001816 ( Pmc/Curation ); précédent : 001815; suivant : 001817Strategies for Avoiding Complications with Vascularized Bone Flaps in Head and Neck Microvascular Reconstruction
Auteurs : David A. Mitchell [Royaume-Uni] ; Stephen P. R. Macleod [États-Unis]Source :
- Seminars in Plastic Surgery [ 1535-2188 ] ; 2008.
Abstract
Effective osseous reconstruction of the head and neck after congenital, traumatic, and particularly ablative oncologic procedures is a relatively recent innovation. Whereas pioneers led with individual donor sites, it is only in the past 20 years that most centers have developed teams comfortable with use of the four common donor sites for free flaps: iliac crest, fibula, radius, and scapula. Calvarium, though much less frequently used, is a useful donor site for specific reconstructive challenges. Less commonly used sites such as femur, humerus, and rib have not proved universally reliable. This article aims to illustrate some refinements and pitfalls in vascularized osseous reconstruction of the head and neck using the well-recognized flaps, including calvarium, in a variety of pathologic conditions, recipient-site defects, and comorbidities. Strategies for error avoidance will be emphasized. The authors hope that this will support the concept of a reconstructive “toolbox” for this complex area.
Url:
DOI: 10.1055/s-2008-1081401
PubMed: 20567712
PubMed Central: 2884885
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<front><div type="abstract" xml:lang="en"><title>ABSTRACT</title>
<p>Effective osseous reconstruction of the head and neck after congenital, traumatic, and particularly ablative oncologic procedures is a relatively recent innovation. Whereas pioneers led with individual donor sites, it is only in the past 20 years that most centers have developed teams comfortable with use of the four common donor sites for free flaps: iliac crest, fibula, radius, and scapula. Calvarium, though much less frequently used, is a useful donor site for specific reconstructive challenges. Less commonly used sites such as femur, humerus, and rib have not proved universally reliable. This article aims to illustrate some refinements and pitfalls in vascularized osseous reconstruction of the head and neck using the well-recognized flaps, including calvarium, in a variety of pathologic conditions, recipient-site defects, and comorbidities. Strategies for error avoidance will be emphasized. The authors hope that this will support the concept of a reconstructive “toolbox” for this complex area.</p>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Semin Plast Surg</journal-id>
<journal-title>Seminars in Plastic Surgery</journal-title>
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<title-group><article-title xml:lang="en">Strategies for Avoiding Complications with Vascularized Bone Flaps in Head and Neck Microvascular Reconstruction</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Mitchell</surname>
<given-names>David A.</given-names>
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<xref rid="a22175-1" ref-type="aff">1</xref>
<degrees>M.B.B.S., B.D.S., F.D.S.R.C.P.S., F.D.S.R.C.S., F.R.C.S. (Ed), F.R.C.S. (Eng), F.R.C.S. (MaxFac)</degrees>
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<contrib contrib-type="author"><name><surname>MacLeod</surname>
<given-names>Stephen P.R.</given-names>
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<degrees>M.B.Ch.B., B.D.S., F.D.S.R.C.S. (Eng), F.D.S.R.C.S. (Ed), F.R.C.S. (Ed), F.R.C.S. (MaxFac)</degrees>
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Oral & Maxillofacial Surgery and Head & Neck Cancer Services, Mid-Yorkshire Hospitals, Wakefield, United Kingdom</aff>
<aff id="a22175-2"><label>2</label>
Oral and Maxillofacial Surgery, Hennepin County Medical Center, Minneapolis, Minnesota</aff>
<author-notes><corresp>Address for correspondence and reprint requests: David A. Mitchell M.B.B.S., B.D.S., F.D.S.R.C.P.S., F.D.S.R.C.S., F.R.C.S. (Ed), F.R.C.S. (Eng), F.R.C.S. (MaxFac) <institution>Oral and Facial Specialties, Pinderfields Hospital</institution>
<addr-line>Aberford Road, Wakefield, WF1 4DG, UK</addr-line>
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<pub-date pub-type="ppub"><month>8</month>
<year>2008</year>
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<volume>22</volume>
<issue>3</issue>
<fpage>175</fpage>
<lpage>185</lpage>
<copyright-statement>© Thieme Medical Publishers</copyright-statement>
<abstract xml:lang="en"><title>ABSTRACT</title>
<p>Effective osseous reconstruction of the head and neck after congenital, traumatic, and particularly ablative oncologic procedures is a relatively recent innovation. Whereas pioneers led with individual donor sites, it is only in the past 20 years that most centers have developed teams comfortable with use of the four common donor sites for free flaps: iliac crest, fibula, radius, and scapula. Calvarium, though much less frequently used, is a useful donor site for specific reconstructive challenges. Less commonly used sites such as femur, humerus, and rib have not proved universally reliable. This article aims to illustrate some refinements and pitfalls in vascularized osseous reconstruction of the head and neck using the well-recognized flaps, including calvarium, in a variety of pathologic conditions, recipient-site defects, and comorbidities. Strategies for error avoidance will be emphasized. The authors hope that this will support the concept of a reconstructive “toolbox” for this complex area.</p>
</abstract>
<kwd-group xml:lang="en"><kwd>Error avoidance</kwd>
<kwd>microsurgery</kwd>
<kwd>head and neck</kwd>
<kwd>osseous free flaps</kwd>
</kwd-group>
<custom-meta-wrap><custom-meta><meta-name>issue-theme</meta-name>
<meta-value>New Horizons in Vascularized Bone Grafts</meta-value>
</custom-meta>
<custom-meta><meta-name>issue-editor</meta-name>
<meta-value>Guest Editors
Steven L. Moran M.D.
Deepak Kademani D.M.D., M.D., F.A.C.S.
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</custom-meta>
</custom-meta-wrap>
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