New Technique Safer and Faster for Cancer Patients Undergoing Head and Neck Reconstruction

By HospiMedica International staff writers
Posted on 13 Dec 2024

Image: Reconstruction of neck skin and jawbone using a pedicled LD flap (Photo courtesy of OMU)

Head and neck reconstruction is essential in the treatment of patients with head and neck cancer, aiming to preserve vital functions such as breathing, eating, and speaking, while also maintaining appearance and quality of life. Researchers have now introduced an innovative technique for head and neck reconstruction that shifts the positioning of transferred tissue with attached blood vessels, offering a safer and faster alternative for patients with complex tissue defects, particularly those at high risk.

Traditional reconstruction methods often involve free flaps, which may not be suitable for certain patients, such as those who have undergone prior radiation treatment or multiple surgeries. A free flap involves detaching a section of tissue from a healthy donor site and reattaching it to new blood vessels at the recipient site. However, the research team at Osaka Metropolitan University (Osaka, Japan) took a different approach by using pedicled latissimus dorsi (LD) myocutaneous flaps, which remain partially attached to the donor site, preserving their natural blood supply as they are relocated to the recipient site for reconstruction.

While the LD flap has been used in various reconstructive procedures, the team developed a novel technique by positioning the skin portion of the LD flap more distally on the back, compared to traditional methods. This design incorporates the lateral cutaneous branch of the 10th posterior intercostal artery, ensuring a reliable blood flow to the flap. The study, which was conducted from 2003 to 2024, showed that the pedicled LD flap was successfully integrated in all 22 patients with complex head and neck defects. The results of the study were published in the journal Plastic and Reconstructive Surgery—Global Open.

“Traditional reconstruction typically uses free flaps, which may not be feasible for some patients, such as those who have had prior radiation treatment or multiple surgeries,” said Tsubasa Kojima, a medical doctor and lecturer at Osaka Metropolitan University’s Graduate School of Medicine and lead author of the study. “This setup provides flexibility, allowing the LD flap to cover extensive defects, including those in both the mouth and neck simultaneously, and even facilitates jaw reconstruction by incorporating rib bone.”