Maneuvers in Regional Flap Use in Reconstruction of Primary Defects in Head and Neck Cancer Patients: Presentation of Three Cases

This case series highlights the advantages in the use of three regional fl aps, submental fl ap, sternocleidomastoid fl ap and transverse cervical fl ap in maxillofacial primary defect reconstruction after ablative cancer surgery through presentation of three head and neck cancer patients in whom it was decided to do pedicled fl aps rather than free fl aps. Aim and objective: This article is done in an attempt for en couraging for more introduction of these three fl aps in head and neck reconstruction practice, and to encourage more studies be done to describe skin territory of cervical fl ap. Materials and methods: Three patients presented to oral and maxillofacial department, diagnosed as having different kinds of cancer. All were managed according to the evidence-based guideline of head and neck cancer management, including the work up, diagnosis, TNM classifi cation, surgical treatment, adjuvant treatment and follow-up. In all the three cases, regional fl aps were used to close the primary defect. For the fi rst patient, transverse cervical fl ap was used, the sternocleidomastoid fl ap in the second and submental fl ap in the third one. Results: All fl aps were easy to be harvested, in term of time and technique, and successful in term of viability, extension and in achieving the functional and cosmetic aim of reconstruction, with minimum donor site morbidity, all the patient are enjoying good quality of life. Conclusion and recommendations: The regional fl aps have their place to overcome limitation of free fl aps due to the shortage in the armamentarium available in the hospital, especially in low resources regions, or limitations related to patients general condition, in addition, regional fl aps are the best option available in case of failed free fl ap, or when free fl ap failure is anticipated and avoided. Highlighting the different maneuvers in harvesting and using regional pedicled fl aps for further extensions widens the scope of indications and giving the reconstructive surgeon variability of options in reconstruction, obviates the need for special microvascular expertise in free fl aps with comparable results and relatively less complication.