Flow Chart for Reconstructive Head and Neck Surgery in Composite Soft and Hard Tissue Defects

Journal of Craniofacial Surgery, vol. 31, pp. e588–e591

Abstract

INTRODUCTION: Virtual planning of reconstructive surgical procedures in patients with osseous and composite defects in the head and neck region is becoming increasingly a state of the art modality. However, computational algorithms lack the capability of planning the involved soft tissue and vascular pedicle position. The authors present a flow-chart to solve this problem in the reconstruction of defects of the upper and lower jaw. MATERIAL AND METHODS: Clinical records from 2013 to 2018 from a tertiary care center were screened for patients undergoing osseous reconstruction in the head and neck region. A flow-chart considering soft tissue positioning and the anatomical course of the vascular pedicle was assessed in consideration of the defect and donor-site. RESULTS: A total of 81 osseous and composite microvascular reconstructive procedures have been conducted. Defects of the lower jaw were the most common (n = 61). The free fibula flap was the most common reconstructive measure and showed a wide versatility of surgical options to reconstruct these defects. The flow charts were assessed accordingly in these procedures. CONCLUSION: Soft tissue and vascular pedicle positioning can be planned pre-operatively by the use of virtual planning and should be considered as an enhancement tool to the already existing computational algorithms of planning hard tissue reconstruction.

Authors 7

1. Bernd Lethaus corresponding

   Leipzig University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, Leipzig University, Leipzig, Germany

2. Mohammad Kamal

   Kuwait University

   Affiliation as printed

   Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait

3. Franziska Kettner Aachen Department of Oral, Maxillofacial and Plastic Facial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Aachen, University, Aachen, Germany

4. Anita Kloss‐Brandstätter

   FH Kärnten

   Affiliation as printed

   Carinthia University of Applied Sciences, Villach, Austria

5. Dirk Halama corresponding

   Leipzig University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, Leipzig University, Leipzig, Germany

6. Frank Hölzle Aachen Department of Oral, Maxillofacial and Plastic Facial Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Oral, Maxillofacial and Plastic Facial Surgery, University Hospital of Aachen, University, Aachen, Germany

7. Alexander Karl-Heinz Bartella corresponding

   Leipzig University

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery, Leipzig University, Leipzig, Germany