PURPOSE Bilateral maxillectomy defects, if not adequately reconstructed, can result in grave esthetic and functional problems. The purpose of this study was to investigate the outcome of reconstruction of such defects. MATERIALS AND METHODS This is a retrospective case series. The defects were analyzed for their components and the flaps used for reconstruction. Outcomes for flap loss and func...

BACKGROUND The optimum number of microvascular anastomoses for safe free tissue transfer is controversial. Although the case for 2 venous anastomoses versus 1 anastomosis has been argued, the use of an additional arterial anastomosis has not been examined in detail. METHODS Twelve patients who underwent 2 arterial anastomoses for a free flap transfer were identified retrospectively from the m...

IMPORTANCE Minimizing morbidity when performing free flap reconstruction of the head and neck is important in the overall reconstructive paradigm. OBJECTIVE To examine the indications and success rates of free tissue transfer using small-caliber facial recipient vessels and minimal access incisions. DESIGN, SETTING, AND PARTICIPANTS Retrospective medical record review of patients with head ...

AIM In the literature currently available monitoring devices are usually divided into two major groups: those for monitoring perfusion and those for measuring tissue oxygenation. The O(2)C (oxygen to see) system combines these two ways of monitoring free flap viability. The aim of this prospective study was to determine the necessity of flap revision and when unnecessary revision can be avoided...

BACKGROUND Ablative orofacial defects incorporating mimetic facial musculature/nerve cause hemifacial expressive dysfunction and considerable morbidity but are rarely reanimated immediately using free functioning gracilis myocutaneous flaps. METHODS Disrupted buccal branches provided a recipient facial nerve for 24 gracilis reinnervations. An additional 15 free flaps were used for extensive c...

BACKGROUND Current teaching suggests increased perfusion in free transverse rectus abdominis myocutaneous (TRAM) flaps over pedicled TRAM flaps, broadening indications for its use in high risk patients. This study compared perfusion analysis of free muscle-sparing versus pedicle TRAM flaps in vivo in the peri-operative and late post-operative periods. METHODS The SPY-Elite system using indocy...

We have found prefabrication of hairless radial forearm free flap to be a useful technique for nasal reconstruction. Prior skin grafting and a suitable period of maturation permits safe, reliable surgery. Its use should be considered in those patients whose forehead tissue is not suitable or in whom appropriate distant flaps are not available, as is often the case with hirsute males.

Background: Despite excellent results from free flap transfers, postoperative thrombosis does occur and, although infrequent, causes total loss of the flap. We investigate the risk factors of anastomotic thrombosis in head and neck free flaps. Study Design, Subjects and Methods: A retrospective analysis was carried out on 200 consecutive free flaps applied to patients who underwent head and nec...