Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience.

Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.

Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.

Closure of the osteocutaneous fibula flap donor site with a tonearm (propeller) flap: Anatomic considerations and surgical indications.

Background: Skin graft is frequently used for donor site closure after osteocutaneous fibula free flap (OCFFF) harvest when primary closure is not possible. Partial skin graft loss requiring wound care is a common complication. The purposes of this prospective study were to investigate the perforator anatomy for local propeller or tonearm flap closure and compare the outcomes to those of skin graft closure.

Optimizing Osteotomy Geometries in Posterolateral Mandibulectomies.

Importance: Reconstructive stability after mandibulectomy with osseous autogenous transplant is influenced by masticatory forces and the resulting stress on the titanium plate.

Objective: To determine an optimal geometry of mandibular osteotomy that minimizes undesirable loading of the reconstruction plate.

Design, Setting, And Participants: In this combined in silico and in vitro basic science study, segmented computed tomography images of an adult male human mandible downloaded from the Visible Human Project were analyzed.

Maxillary Reconstruction with Free Vascularized Fibula: 15-Year Experience.

Background: Reconstruction of the midface after maxillectomy is extremely challenging due to the need to reestablish the contour of the midface, maintain oronasal separation, support the orbit, and to restore the dentition. In this study, we present our specific technique, surgical and functional outcomes, and pitfalls to avoid for reconstruction of the midface with the fibula osteocutaneous free flap.

Methods: A retrospective review of patients who underwent maxillary reconstruction with a fibula osteocutaneous free flap was performed.

Free fibula mandible reconstruction for osteoradionecrosis is more challenging than for primary cancer.

Introduction: Osteoradionecrosis (ORN) of the mandible is an unfortunate potential sequela of radiotherapy for head and neck cancer. In advanced cases of ORN, mandibulectomy, and free fibula flap reconstruction are required. We hypothesized that patients undergoing fibula free flap reconstruction and mandibulectomy for ORN pose unique challenges and experience more complications than patients undergoing fibula free flaps after oncologic mandibulectomy.