BibTex RIS Cite

The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects

Year 2010, Volume: 20 Issue: 5, 226 - 231, 15.10.2010

Abstract

Objectives: To compare and contrast the use of the latissimus dorsi myocutaneous flap in complex head and neck defects requiring major reconstructive surgery with respect to the other reconstruction techniques, and to emphasize the importance of this flap as an life and surgeon-saving reconstruction modality. Patients and Methods: In this study, 20 cases 17 males, 3 females; mean age 58.5 years; range 48 to 72 years of major head and neck operations reconstructed with a latissimus dorsi myocutaneous flap in İstanbul University, İstanbul Medical Faculty, Ear, Nose and Throat Clinic between October 2004 and November 2006 were retrospectively examined. The latissimus dorsi myocutaneous flap was prefered as a primary reconstructive modality in eight of the cases and a secondary reconstructive modality in the remaining 12 cases. The reasons for choosing the latissimus dorsi myocutaneous flap as the reconstructive modality were examined in this study and compared with other reconstruction techniques. Results: Partial flap necrosis was observed in four of the 20 cases. In two of these unsuccessful cases, minor intervention was sufficient to achieve functionally satisfactory results. However, one case with partial flap necrosis was lost due to the uncontrollable primary disease. In the one remaining case who had undergone cranioplasty, partial necrosis of the flap developed after the completion of radiotherapy in the 4th postoperative month. No total flap necrosis was encountered in any of the cases. Conclusion: The latissimus dorsi myocutaneous flap is a reconstructive modality with a high success rate and should be considered among reconstruction alternatives.

References

  • Har-El G, Bhaya M, Sundaram K. Latissimus dorsi myocutaneous flap for secondary head and neck reconstruction. Am J Otolaryngol 1999;20:287-93.
  • Shindo ML, Sullivan MJ. Muscular and myocutane- ous pedicled flaps. Otolaryngol Clin North Am 1994; 27:161-72.
  • Urken ML, Cheney ML, Sullivan MJ. Atlas of regional and free flaps for head and neck reconstruction. New York: Lippincott Williams & Wilkins; 1995.
  • Haughey BH, Fredrickson JM. The latissimus dorsi donor site. Current use in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1991;117:1129-34.
  • Schuller DE. Latissimus dorsi myocutaneous flap for massive facial defects. Arch Otolaryngol 1982;108:414-7.
  • Barton FE Jr, Spicer TE, Byrd HS. Head and neck recon- struction with the latissimus dorsi myocutaneous flap: anatomic observations and report of 60 cases. Plast Reconstr Surg 1983;71:199-204.
  • Maves MD, Panje WR, Shagets FW. Extended latissi- mus dorsi myocutaneous flap reconstruction of major head and neck defects. Otolaryngol Head Neck Surg 1984;92:551-8.
  • Sabatier RE, Bakamjian VY, Carter WL. Craniofacial and head and neck applications of the transaxillary latissimus dorsi flap. Ear Nose Throat J 1992;71:173-82.
  • Chowdhury CR, McLean NR, Harrop-Griffiths K, Breach NM. The repair of defects in the head and neck region with the latissimus dorsi myocutaneous flap. J Laryngol Otol 1988;102:1127-32.
  • Seckel BR, Upton J, Freidberg SR, Gilbert KP, Murray JE. Pedicled myocutaneous flap of latissimus dorsi muscle for reconstruction of anterior and middle skull defects: an alternative. Head Neck Surg 1986;8:165-8.
  • Quillen CG. Latissimus dorsi myocutaneous flaps in head and neck reconstruction. Plast Reconstr Surg 1979;63:664-70.
  • Morris RL, Given KS, McCabe JS. Repair or head and neck defects with the latissimus dorsi myocutaneous flap. Am Surg 1981;47:167-73.
  • Tobin GR, Moberg AW, DuBou RH, Weiner LJ, Bland KI. The split latissimus dorsi myocutaneous flap. Ann Plast Surg 1981;7:272-80.

Kompleks baş boyun defektlerinin rekonstrüksiyonunda latissimus dorsi kas deri flebi kullanımı

Year 2010, Volume: 20 Issue: 5, 226 - 231, 15.10.2010

Abstract

Amaç: Kompleks baş boyun defeklerinin cerrahisinde majör rekonstrüksiyon gerektiren olgularda latissimus dorsi kas deri flebi kullanımı diğer karşıt rekonstrüksiyon yöntemleri ile karşılaştırılarak irdelendi ve bu flebin yaşamsal önemi ve alternatif bir rekonstrüksiyon yöntemi olarak bilinmesi gerektiği vurgulandı.Hastalar ve Yöntemler: Bu çalışmada Ekim 2004 - Kasım 2006 tarihleri arasında İstanbul Üniversitesi İstanbul Tıp Fakültesi Kulak Burun Boğaz Kliniği’nde gerçekleştirilen ve latissimus dorsi kas deri flebi kullanılarak 20 olguda 17 erkek, 3 kadın; ort. yaş 58.5 yıl; dağılım 48-72 yıl yapılan majör baş boyun rekonstrüksiyon ameliyatları geriye dönük olarak incelendi. Latissimus dorsi kas deri flebi olguların sekizinde birincil rekonstrüksiyon yöntemi, geri kalan 12’sinde ise ikincil rekonstrüksiyon yöntemi olarak tercih edildi. Çalışmada temel olarak latissimus dorsi kas deri flebinin bir rekonstrüksiyon yöntemi olarak neden tercih edildiği araştırıldı ve diğer rekonstrüksiyon yöntemleri ile karşılaştırıldı.Bulgular: Yirmi olgudan dördünde kısmi flep nekrozu gözlendi. Bunlardan başarısız olan iki olguda minör girişimler ile fonksiyonel olarak tatmin edici sonuçlar alındı. Ancak, kısmi flep nekrozu gelişen bir olgu birincil hastalığın kontrol edilememesine bağlı olarak kaybedildi. Kraniyoplasti yapılmış olan diğer bir olguda ise ameliyat sonrası 4. ayda radyasyon tedavisinin bitimini takiben flepte parsiyel nekroz gelişti. Hiçbir olguda total flep nekrozu ile karşılaşılmadı.Sonuç: Latissimus dorsi kas deri flebi, baş boyun rekonstrüksiyonunda başarı oranı yüksek olan ve rekonstrüksiyon seçenekleri arasında mutlaka bulundurulması gereken bir yöntemdir

References

  • Har-El G, Bhaya M, Sundaram K. Latissimus dorsi myocutaneous flap for secondary head and neck reconstruction. Am J Otolaryngol 1999;20:287-93.
  • Shindo ML, Sullivan MJ. Muscular and myocutane- ous pedicled flaps. Otolaryngol Clin North Am 1994; 27:161-72.
  • Urken ML, Cheney ML, Sullivan MJ. Atlas of regional and free flaps for head and neck reconstruction. New York: Lippincott Williams & Wilkins; 1995.
  • Haughey BH, Fredrickson JM. The latissimus dorsi donor site. Current use in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1991;117:1129-34.
  • Schuller DE. Latissimus dorsi myocutaneous flap for massive facial defects. Arch Otolaryngol 1982;108:414-7.
  • Barton FE Jr, Spicer TE, Byrd HS. Head and neck recon- struction with the latissimus dorsi myocutaneous flap: anatomic observations and report of 60 cases. Plast Reconstr Surg 1983;71:199-204.
  • Maves MD, Panje WR, Shagets FW. Extended latissi- mus dorsi myocutaneous flap reconstruction of major head and neck defects. Otolaryngol Head Neck Surg 1984;92:551-8.
  • Sabatier RE, Bakamjian VY, Carter WL. Craniofacial and head and neck applications of the transaxillary latissimus dorsi flap. Ear Nose Throat J 1992;71:173-82.
  • Chowdhury CR, McLean NR, Harrop-Griffiths K, Breach NM. The repair of defects in the head and neck region with the latissimus dorsi myocutaneous flap. J Laryngol Otol 1988;102:1127-32.
  • Seckel BR, Upton J, Freidberg SR, Gilbert KP, Murray JE. Pedicled myocutaneous flap of latissimus dorsi muscle for reconstruction of anterior and middle skull defects: an alternative. Head Neck Surg 1986;8:165-8.
  • Quillen CG. Latissimus dorsi myocutaneous flaps in head and neck reconstruction. Plast Reconstr Surg 1979;63:664-70.
  • Morris RL, Given KS, McCabe JS. Repair or head and neck defects with the latissimus dorsi myocutaneous flap. Am Surg 1981;47:167-73.
  • Tobin GR, Moberg AW, DuBou RH, Weiner LJ, Bland KI. The split latissimus dorsi myocutaneous flap. Ann Plast Surg 1981;7:272-80.
There are 13 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

İsmet Aslan This is me

Yusufhan Süoğlu This is me

Bora Başaran This is me

Günter Hafız This is me

Publication Date October 15, 2010
Published in Issue Year 2010 Volume: 20 Issue: 5

Cite

APA Aslan, İ., Süoğlu, Y., Başaran, B., Hafız, G. (2010). The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects. The Turkish Journal of Ear Nose and Throat, 20(5), 226-231.
AMA Aslan İ, Süoğlu Y, Başaran B, Hafız G. The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects. Tr-ENT. October 2010;20(5):226-231.
Chicago Aslan, İsmet, Yusufhan Süoğlu, Bora Başaran, and Günter Hafız. “The Use of the Latissimus Dorsi Myocutaneous Flap in the Reconstruction of Complex Head and Neck Defects”. The Turkish Journal of Ear Nose and Throat 20, no. 5 (October 2010): 226-31.
EndNote Aslan İ, Süoğlu Y, Başaran B, Hafız G (October 1, 2010) The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects. The Turkish Journal of Ear Nose and Throat 20 5 226–231.
IEEE İ. Aslan, Y. Süoğlu, B. Başaran, and G. Hafız, “The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects”, Tr-ENT, vol. 20, no. 5, pp. 226–231, 2010.
ISNAD Aslan, İsmet et al. “The Use of the Latissimus Dorsi Myocutaneous Flap in the Reconstruction of Complex Head and Neck Defects”. The Turkish Journal of Ear Nose and Throat 20/5 (October 2010), 226-231.
JAMA Aslan İ, Süoğlu Y, Başaran B, Hafız G. The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects. Tr-ENT. 2010;20:226–231.
MLA Aslan, İsmet et al. “The Use of the Latissimus Dorsi Myocutaneous Flap in the Reconstruction of Complex Head and Neck Defects”. The Turkish Journal of Ear Nose and Throat, vol. 20, no. 5, 2010, pp. 226-31.
Vancouver Aslan İ, Süoğlu Y, Başaran B, Hafız G. The use of the latissimus dorsi myocutaneous flap in the reconstruction of complex head and neck defects. Tr-ENT. 2010;20(5):226-31.