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Pediatric free flap reconstruction for head and neck defects

Roasa, Francis V.a; Castañeda, Samantha S.b; Mendoza, Daniel Jose C.c

Current Opinion in Otolaryngology & Head and Neck Surgery: October 2018 - Volume 26 - Issue 5 - p 334–339
doi: 10.1097/MOO.0000000000000473
HEAD AND NECK RECONSTRUCTION: Edited by Arnaud F. Bewley
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Purpose of review The aim of this study was to review recent literature on the use of pediatric free flap reconstruction for head and neck defects with focus on skull base, congenital deformities, mandibular reconstruction and operative considerations.

Recent findings Reconstruction of the skull base depends on the defect size, location, bony involvement, and pedicle length with a variety of flaps to choose from. Free flaps may be used to correct congenital anomalies due to facial clefts and syndromic causes requiring bony and tissue bulk. Preservation of the condyle together with free flap mandibular reconstruction has better growth potential. Delayed repair of mandibular defects may be an option especially for patients with malignancy. Chemotherapy and radiation therapy may inhibit the growth potential of the mandible. The use of running or coupled arterial anastomosis is associated with an increased immediate complication.

Summary Pediatric free flap reconstruction is a reasonable option for various head and neck defects such as skull base, congenital, and mandibular defects.

aDepartment of Otolaryngology-Head and Neck Surgery, Faculty of Medicine & Surgery, University of Santo Tomas, University of Santo Tomas Hospital

bDepartment of Otolaryngology-Head and Neck Surgery, The Medical City, Ortigas Center, Pasig City

cDepartment of Otorhinolaryngology-Head and Neck Surgery, Jose R. Reyes Memorial Medical Center, San Lazaro Compound, Rizal Avenue Sta. Cruz, Manila, Philippines

Correspondence to Daniel Jose C. Mendoza, MD, Department of Otorhinolaryngology-Head and Neck Surgery, Jose R. Reyes Memorial Medical Center, San Lazaro Compound, Rizal Avenue Sta. Cruz, Manila 1003 Philippines. Tel: +632 743 6921; e-mail: danieljosemendoza@yahoo.com.ph

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