Presentations 2020: OMFS

364 - Reconstruction of Large Craniofacial Soft Tissue Defects Using Free Tissue Transfer

R Devine N Scott
Presented by: Robert Devine
Cardiff Dental Hospital

Introduction Curative surgery of both benign and malignant head and neck cancers present significant reconstructive challenges to the surgeon. With the results of surgery having an impact on patient quality of life. Our unit recently treated 3 cases that required areas in excess of 225cm2 to be reconstructed. All three cases were reconstructed with Anterolateral Thigh free flaps. The management of these cases and the outcomes will be discussed. Discussion The case in focus describes the excision of a large Cutaneous Squamous Cell Carcinoma from the left scalp with a left neck radical dissection type 2, left superficial parotidectomy and reconstruction using an abdominal skin graft. Following pathological assessment, adjuvant treatment was required in the form of radiotherapy. Unfortunately the patient developed Osteoradionecrosis (ORN) of the parietal bone with failure of the initial skin graft. The progression of ORN required radical surgery. The left parietal bone was resected and the large cranial defect was reconstructed utilising an anterolateral thigh free flap. Ultimately the latter surgery was successful from both a clinical and patient centred perspective, with good outcomes regarding patient satisfaction, quality of life and absence of free flap post-operative complications. Conclusion The successful reconstruction of three large craniofacial defects using Anterolateral Thigh free flaps, and long-term outcomes for patients following these surgeries will be discussed.
Consent Statement: Written informed consent for publication of their clinical details and/or clinical images was obtained from the patient/parent/guardian. A copy of the consent form is available for review by the the meeting organisers..

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