The field of head and neck surgery has gone through numerous changes in the past two decades. Microvascular free flap reconstructions largely replaced other techniques. More importantly, there has been a paradigm shift toward seeking not only to achieve reliable wound closure to protect vital structures, but also to reestablish normal function and appearance. The present paper will present an algorithmic approach to head and neck reconstruction of various subsites, using an evidence-based approach wherever possible. 1. Introduction The field of head and neck reconstructive surgery is a dynamic one. Advances made in the last decade are mostly secondary to expanded use of microvascular free flaps [1]. Several flaps, including the anterolateral thigh, fibula osteocutaneous, and suprafascial radial forearm fasciocutaneous free flaps, have emerged as workhorse flaps for reconstructing a wide variety of defects. As the anatomy of these flaps has become more familiar, their reliability and versatility have increased. Reliable wound closure without exposure of vital structures is no longer the only priority. Preserving function, including speech and swallowing, and restoring appearance are the goals in every reconstruction. Free flap success rates now routinely exceed 95 percent or better at most centers [1–3]. On top of this, minimizing flap donor site morbidity is an important consideration. Because of the high rate of recurrence as well as long-term complications following major head and neck resections and reconstructions, preservation of recipient vessel options and flap donor sites should also be a consideration. In the following paper, an algorithmic approach to mid-facial, mandibular, oral cavity, and pharyngoesophageal reconstruction will be reviewed and expected outcomes discussed. 2. Mid-Facial Reconstruction Management of mid-facial defects is among the most complicated and controversial areas of head and neck oncologic reconstruction. Options include use of prosthetic obturators, pedicled flaps, and free flaps, sometimes combined with grafts or alloplasts [4]. The popularity of pedicled flaps has declined in recent years due to limited reach and volume. Prosthetic obturators remain a good solution for some patients with limited defects. For extensive defects, obturators may be difficult or impossible to retain, particularly in edentulous patients [5]. Furthermore, obturators are inappropriate for defects that involve resection of the skull base, orbital contents, orbital floor, or soft tissues of the face. Finally, some patients may not like the
References
[1]
M. M. Hanasono, M. T. Friel, C. Klem et al., “Impact of reconstructive microsurgery in patients with advanced oral cavity cancers,” Head and Neck, vol. 31, no. 10, pp. 1289–1296, 2009.
[2]
D. A. Hidalgo, J. J. Disa, P. G. Cordeiro, and Q.-Y. Hu, “A review of 716 consecutive free flaps for oncologic surgical defects: refinement in donor-site selection and technique,” Plastic and Reconstructive Surgery, vol. 102, no. 3, pp. 722–732, 1998.
[3]
K. E. Blackwell, “Unsurpassed reliability of free flaps for head and neck reconstruction,” Archives of Otolaryngology: Head and Neck Surgery, vol. 125, no. 3, pp. 295–299, 1999.
[4]
S. Archibald, S. Jackson, and A. Thoma, “Paranasal sinus and midfacial reconstruction,” Clinics in Plastic Surgery, vol. 32, no. 3, pp. 309–325, 2005.
[5]
D. J. Okay, E. Genden, D. Buchbinder, and M. Urken, “Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects,” The Journal of Prosthetic Dentistry, vol. 86, no. 4, pp. 352–363, 2001.
[6]
Y.-M. Chang, O. K. Coskunfirat, F.-C. Wei, C.-Y. Tsai, and H.-N. Lin, “Maxillary reconstruction with a fibula osteoseptocutaneous free flap and simultaneous insertion of osseointegrated dental implants,” Plastic and Reconstructive Surgery, vol. 113, no. 4, pp. 1140–1145, 2004.
[7]
X. Peng, C. Mao, G.-Y. Yu, C.-B. Guo, M.-X. Huang, and Y. Zhang, “Maxillary reconstruction with the free fibula flap,” Plastic and Reconstructive Surgery, vol. 115, no. 6, pp. 1562–1569, 2005.
[8]
S. Yazar, M.-H. Cheng, F.-C. Wei, S.-P. Hao, and K.-P. Chang, “Osteomyocutaneous peroneal artery perforator flap for reconstruction of composite maxillary defects,” Head and Neck, vol. 28, no. 4, pp. 297–304, 2006.
[9]
J. R. Clark, M. Vesely, and R. Gilbert, “Scapular angle osteomyogenous flap in postmaxillectomy reconstruction: defect, reconstruction, shoulder function, and harvest technique,” Head and Neck, vol. 30, no. 1, pp. 10–20, 2008.
[10]
E. M. Genden, D. Wallace, D. Buchbinder, D. Okay, and M. L. Urken, “Iliac crest internal oblique osteomusculocutaneous free flap reconstruction of the postablative palatomaxillary defect,” Archives of Otolaryngology—Head and Neck Surgery, vol. 127, no. 7, pp. 854–861, 2001.
[11]
J. S. Brown, D. C. Jones, A. Summerwill et al., “Vascularized iliac crest with internal oblique muscle for immediate reconstruction after maxillectomy,” British Journal of Oral and Maxillofacial Surgery, vol. 40, no. 3, pp. 183–190, 2002.
[12]
R. H. Spiro, E. W. Strong, and J. P. Shah, “Maxillectomy and its classification,” Head and Neck, vol. 19, no. 4, pp. 309–314, 1997.
[13]
M. A. Moreno, R. J. Skoracki, E. Y. Hanna, and M. M. Hanasono, “Microvascular free flap reconstruction versus palatal obturation for maxillectomy defects,” Head and Neck, vol. 32, no. 7, pp. 860–868, 2010.
[14]
E. M. Genden, D. Okay, M. T. Stepp et al., “Comparison of functional and quality-of-life outcomes in patients with and without palatomaxillary reconstruction: a preliminary report,” Archives of Otolaryngology—Head and Neck Surgery, vol. 129, no. 7, pp. 775–780, 2003.
[15]
S. N. Rogers, D. Lowe, D. McNally, J. S. Brown, and E. D. Vaughan, “Health-related quality of life after maxillectomy: a comparison between prosthetic obturation and free flap,” Journal of Oral and Maxillofacial Surgery, vol. 61, no. 2, pp. 174–181, 2003.
[16]
P. G. Cordeiro and E. Santamaria, “A classification system and algorithm for reconstruction of maxillectomy and midfacial defects,” Plastic and Reconstructive Surgery, vol. 105, no. 7, pp. 2331–2346, 2000.
[17]
M. M. Hanasono, A. K. Silva, P. Yu, and R. J. Skoracki, “A comprehensive algorithm for oncologic maxillary reconstruction,” Plastic and Reconstructive Surgery, vol. 131, no. 1, pp. 47–60, 2013.
[18]
P. G. Cordeiro and C. M. Chen, “A 15-year review of mid-face reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes,” Plastic and Reconstructive Surgery, vol. 129, no. 1, pp. 124–136, 2012.
[19]
M. M. Hanasono and R. J. Skoracki, “The omega-shaped fibula osteocutaneous free flap for reconstruction of extensive midfacial defects,” Plastic and Reconstructive Surgery, vol. 125, no. 4, pp. 160e–162e, 2010.
[20]
J. S. Brown, S. N. Rogers, D. N. McNally, and M. Boyle, “A modified classification for the maxillectomy defect,” Head & Neck, vol. 22, pp. 17–26, 2000.
[21]
J. S. Brown and R. J. Shaw, “Reconstruction of the maxilla and midface: introducing a new classification,” The Lancet Oncology, vol. 11, no. 10, pp. 1001–1008, 2010.
[22]
E. I. Chang, M. W. Clemens, P. B. Garvey, R. J. Skoracki, and M. M. Hanasono, “Cephalometric analysis for microvascular head and neck reconstruction,” Head and Neck, vol. 34, no. 11, pp. 1607–1614, 2012.
[23]
M. M. Hanasono, R. F. Jacob, L. Bidaut, G. L. Robb, and R. J. Skoracki, “Midfacial reconstruction using virtual planning, rapid prototype modeling, and stereotactic navigation,” Plastic and Reconstructive Surgery, vol. 126, no. 6, pp. 2002–2006, 2010.
[24]
P. G. Cordeiro and C. M. Chen, “A 15-year review of midface reconstruction after total and subtotal maxillectomy: part II. Technical modifications to maximize aesthetic and functional outcomes,” Plastic and Reconstructive Surgery, vol. 129, no. 1, pp. 139–147, 2012.
[25]
E. J. Kirby, J. B. Turner, D. L. Davenport, and H. C. Vasconez, “Orbital floor fractures: outcomes of reconstruction,” Annals of Plastic Surgery, vol. 66, no. 5, pp. 508–512, 2011.
[26]
E. D. Rodriguez, M. Martin, R. Bluebond-Langner, M. Khalifeh, N. Singh, and P. N. Manson, “Microsurgical reconstruction of posttraumatic high-energy maxillary defects: establishing the effectiveness of early reconstruction,” Plastic and Reconstructive Surgery, vol. 120, no. 7, 2007.
[27]
M. M. Hanasono, J. C. Lee, J. S. Yang, R. J. Skoracki, G. P. Reece, and B. Esmaeli, “An algorithmic approach to reconstructive surgery and prosthetic rehabilitation after orbital exenteration,” Plastic and Reconstructive Surgery, vol. 123, no. 1, pp. 98–105, 2009.
[28]
M. M. Hanasono, D. S. Utley, and R. L. Goode, “The temporalis muscle flap for reconstruction after head and neck oncologic surgery,” The Laryngoscope, vol. 111, no. 10, pp. 1719–1725, 2001.
[29]
F.-C. Wei, N. Celik, W.-G. Yang, I.-H. Chen, Y.-M. Chang, and H.-C. Chen, “Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap,” Plastic and Reconstructive Surgery, vol. 112, no. 1, pp. 37–42, 2003.
[30]
P. B. Mariani, L. P. Kowalski, and J. Magrin, “Reconstruction of large defects postmandibulectomy for oral cancer using plates and myocutaneous flaps: a long-term follow-up,” International Journal of Oral and Maxillofacial Surgery, vol. 35, no. 5, pp. 427–432, 2006.
[31]
T. Shpitzer, P. J. Gullane, P. C. Neligan et al., “The free vascularized flap and the flap plate options: comparative results of reconstruction of lateral mandibular defects,” Laryngoscope, vol. 110, no. 12, pp. 2056–2060, 2000.
[32]
D. A. Hidalgo, “Fibular free flap: a new method of mandible reconstruction,” Plastic and Reconstructive Surgery, vol. 84, no. 1, pp. 71–79, 1989.
[33]
P. G. Cordeiro, J. J. Disa, D. A. Hidalgo, and Q. Y. Hu, “Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients,” Plastic and Reconstructive Surgery, vol. 104, no. 5, pp. 1314–1320, 1999.
[34]
H. Seikaly, J. Chau, F. Li et al., “Bone that best matches the properties of the mandible,” Journal of Otolaryngology, vol. 32, no. 4, pp. 262–265, 2003.
[35]
G. A. Robertson, “A comparison between sternum and rib in osteomyocutaneous reconstruction of major mandibular defects,” Annals of Plastic Surgery, vol. 17, no. 5, pp. 421–423, 1986.
[36]
B. S. Lutz, F. C. Wei, S. H. Ng, I. H. Chen, and S. H. T. Chen, “Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases,” Plastic and Reconstructive Surgery, vol. 103, no. 1, pp. 121–127, 1999.
[37]
Y.-M. Chang, C. G. Wallace, C.-Y. Tsai, Y.-F. Shen, Y.-M. Hsu, and F.-C. Wei, “Dental implant outcome after primary implantation into double-barreled fibula osteoseptocutaneous free flap-reconstructed mandible,” Plastic and Reconstructive Surgery, vol. 128, no. 6, pp. 1220–1228, 2011.
[38]
B. S. Lutz, F.-C. Wei, S.-H. Ng, I.-H. Chen, and S. H. T. Chen, “Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases,” Plastic and Reconstructive Surgery, vol. 103, no. 1, pp. 121–127, 1999.
[39]
M. M. Hanasono and R. J. Skoracki, “Computer-assisted design and rapid prototype modeling in microvascular mandible reconstruction,” Laryngoscope, vol. 123, no. 3, pp. 597–604, 2013.
[40]
J. P. Levine, A. Patel, P. B. Saadeh, and D. L. Hirsch, “Computer-aided design and manufacturing in craniomaxillofacial surgery: the new state of the art,” Journal of Craniofacial Surgery, vol. 23, no. 1, pp. 288–293, 2012.
[41]
A. K. Antony, W. F. Chen, A. Kolokythas, K. A. Weimer, and M. N. Cohen, “Use of virtual surgery and stereolithography-guided osteotomy for mandibular reconstruction with the free fibula,” Plastic and Reconstructive Surgery, vol. 128, no. 5, pp. 1080–1084, 2011.
[42]
S. M. Shenaq and M. J. A. Klebuc, “Refinements in the iliac crest microsurgical free flap for oromandibular reconstruction,” Microsurgery, vol. 15, no. 12, pp. 825–830, 1994.
[43]
T. ？afak, M. J. A. Klebuc, E. Mavili, and S. M. Shenaq, “A new design of the iliac crest microsurgical free flap without including the “obligatory” muscle cuff,” Plastic and Reconstructive Surgery, vol. 100, no. 7, pp. 1703–1709, 1997.
[44]
A. J. Wagner and S. W. Bayles, “The angular branch: maximizing the scapular pedicle in head and neck reconstruction,” Archives of Otolaryngology—Head and Neck Surgery, vol. 134, no. 11, pp. 1214–1217, 2008.
[45]
M. M. Hanasono and R. J. Skoracki, “The scapular tip osseous free flap as an alternative for anterior mandibular reconstruction,” Plastic and Reconstructive Surgery, vol. 125, no. 4, pp. 164e–166e, 2010.
[46]
S. Seneviratne, C. Duong, and G. I. Taylor, “The angular branch of the thoracodorsal artery and its blood supply to the inferior angle of the scapula: an anatomical study,” Plastic and Reconstructive Surgery, vol. 104, no. 1, pp. 85–88, 1999.
[47]
A. Thoma, R. Khadaroo, O. Grigenas et al., “Oromandibular reconstruction with the radial-forearm osteocutaneous flap: experience with 60 consecutive cases,” Plastic and Reconstructive Surgery, vol. 104, no. 2, pp. 368–378, 1999.
[48]
J. J. Disa, D. A. Hidalgo, P. G. Cordeiro, R. M. Winters, and H. Thaler, “Evaluation of bone height in osseous free flap mandible reconstruction: an indirect measure of bone mass,” Plastic and Reconstructive Surgery, vol. 103, no. 5, pp. 1371–1377, 1999.
[49]
A. Mosahebi, A. Chaudhry, C. M. McCarthy et al., “Reconstruction of extensive composite posterolateral mandibular defects using nonosseous free tissue transfer,” Plastic and Reconstructive Surgery, vol. 124, no. 5, pp. 1571–1577, 2009.
[50]
M. M. Hanasono, J. P. Zevallos, R. J. Skoracki, and P. Yu, “A prospective analysis of bony versus soft-tissue reconstruction for posterior mandibular defects,” Plastic and Reconstructive Surgery, vol. 125, no. 5, pp. 1413–1421, 2010.
[51]
D. A. Hidalgo, “Condyle transplantation in free flap mandible reconstruction,” Plastic and Reconstructive Surgery, vol. 93, no. 4, pp. 770–783, 1994.
[52]
M. K. Wax, C. P. Winslow, J. Hansen et al., “A retrospective analysis of temporomandibular joint reconstruction with free fibula microvascular flap,” Laryngoscope, vol. 110, no. 6, pp. 977–981, 2000.
[53]
F.-C. Wei, F. Demirkan, H.-C. Chen, and I.-H. Chen, “Double free flaps in reconstruction of extensive composite mandibular defects in head and neck cancer,” Plastic and Reconstructive Surgery, vol. 103, no. 1, pp. 39–47, 1999.
[54]
M. M. Hanasono, Y. E. Weinstock, and P. Yu, “Reconstruction of extensive head and neck defects with multiple simultaneous free flaps,” Plastic and Reconstructive Surgery, vol. 122, no. 6, pp. 1739–1746, 2008.
[55]
M. M. Hanasono, Y. Barnea, and R. J. Skoracki, “Microvascular surgery in the previously operated and irradiated neck,” Microsurgery, vol. 29, no. 1, pp. 1–7, 2009.
[56]
Y.-M. Chang, E. Santamaria, F.-C. Wei et al., “Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction,” Plastic and Reconstructive Surgery, vol. 102, no. 3, pp. 680–688, 1998.
[57]
M. L. Urken, D. Buchbinder, H. Weinberg, C. Vickery, A. Sheiner, and H. F. Biller, “Primary placement of osseointegrated implants in microvascular mandibular reconstruction,” Otolaryngology: Head and Neck Surgery, vol. 101, no. 1, pp. 56–73, 1989.
[58]
A. O. Momoh, P. Yu, R. J. Skoracki, S. Liu, L. Feng, and M. M. Hanasono, “A prospective cohort study of fibula free flap donor-site morbidity in 157 consecutive patients,” Plastic and Reconstructive Surgery, vol. 128, no. 3, pp. 714–720, 2011.
[59]
J. Pribaz, W. Stephens, L. Crespo, and G. Gifford, “A new intraoral flap: Facial artery musculomucosal (FAMM) flap,” Plastic and Reconstructive Surgery, vol. 90, no. 3, pp. 421–429, 1992.
[60]
J. J. Pribaz, J. G. Meara, S. Wright, J. D. Smith, W. Stephens, and K. H. Breuing, “Lip and vermilion reconstruction with the facial artery musculomucosal flap,” Plastic and Reconstructive Surgery, vol. 105, no. 3, pp. 864–872, 2000.
[61]
L. Dupoirieux, L. Plane, C. Gard, and M. Penneau, “Anatomical basis and results of the facial artery musculomucosal flap for oral reconstruction,” British Journal of Oral and Maxillofacial Surgery, vol. 37, no. 1, pp. 25–28, 1999.
[62]
D. Martin, J. F. Pascal, J. Baudet et al., “The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap,” Plastic and Reconstructive Surgery, vol. 92, no. 5, pp. 867–873, 1993.
[63]
S. B. Uppin, Q. G. Ahmad, P. Yadav, and K. Shetty, “Use of the submental island flap in orofacial reconstruction—a review of 20 cases,” Journal of Plastic, Reconstructive and Aesthetic Surgery, vol. 62, no. 4, pp. 514–519, 2009.
[64]
O. Magden, M. Edizer, V. Tayfur, and A. Atabey, “Anatomic study of the vasculature of the submental artery flap,” Plastic and Reconstructive Surgery, vol. 114, no. 7, pp. 1719–1723, 2004.
[65]
H. Rikimaru, K. Kiyokawa, Y. Inoue, and Y. Tai, “Three-dimensional anatomical vascular distribution in the pectoralis major myocutaneous flap,” Plastic and Reconstructive Surgery, vol. 115, no. 5, pp. 1342–1352, 2005.
[66]
B. S. Lutz, F.-C. Wei, S. C. N. Chang, K.-H. Yang, and I. Chen, “Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases,” Plastic and Reconstructive Surgery, vol. 103, no. 1, pp. 132–137, 1999.
[67]
S. C. Chang, G. Miller, C. F. Halbert, K. H. Yang, W. C. Chao, and F. C. Wei, “Limiting donor site morbidity by suprafascial dissection of the radial forearm flap,” Microsurgery, vol. 17, no. 3, pp. 136–140, 1996.
[68]
B. H. Haughey, “Tongue reconstruction: concepts and practice,” Laryngoscope, vol. 103, no. 10, pp. 1132–1141, 1993.
[69]
M. L. Urken, J. F. Moscoso, W. Lawson, and H. F. Biller, “A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy,” Archives of Otolaryngology—Head and Neck Surgery, vol. 120, no. 6, pp. 589–601, 1994.
[70]
D. B. Chepeha, T. N. Teknos, J. Shargorodsky et al., “Rectangle tongue template for reconstruction of the hemiglossectomy defect,” Archives of Otolaryngology—Head and Neck Surgery, vol. 134, no. 9, pp. 993–998, 2008.
[71]
P. Yu, E. I. Chang, J. C. Selber, and M. M. Hanasono, “Perforator patterns of the ulnar artery perforator flap,” Plastic and Reconstructive Surgery, vol. 129, no. 1, pp. 213–220, 2012.
[72]
V. Q. Vinh, T. Van Anh, R. Ogawa, and H. Hyakusoku, “Anatomical and clinical studies of the supraclavicular flap: analysis of 103 flaps used to reconstruct neck scar contractures,” Plastic and Reconstructive Surgery, vol. 123, no. 5, pp. 1471–1480, 2009.
[73]
P. H. Liu and E. S. Chiu, “Supraclavicular artery flap: a new option for pharyngeal reconstruction,” Annals of Plastic Surgery, vol. 62, no. 5, pp. 497–501, 2009.
[74]
E. S. Chiu, P. H. Liu, and P. L. Friedlander, “Supraclavicular artery island flap for head and neck oncologic reconstruction: Indications, complications, and outcomes,” Plastic and Reconstructive Surgery, vol. 124, no. 1, pp. 115–123, 2009.
[75]
E. S. Chiu, P. H. Liu, R. Baratelli, M. Y. Lee, A. E. Chaffin, and P. L. Friedlander, “Circumferential pharyngoesophageal reconstruction with a supraclavicular artery Island flap,” Plastic and Reconstructive Surgery, vol. 125, no. 1, pp. 161–166, 2010.
[76]
A. G. Anand, E. J. Tran, C. P. Hasney, P. L. Friedlander, and E. S. Chiu, “Oropharyngeal reconstruction using the supraclavicular artery island flap: a new flap alternative,” Plastic and Reconstructive Surgery, vol. 129, no. 2, pp. 438–441, 2012.
[77]
T. T. Sands, J. B. Martin, E. Simms, M. M. Henderson, P. L. Friedlander, and E. S. Chiu, “Supraclavicular artery island flap innervation: anatomical studies and clinical implications,” Journal of Plastic, Reconstructive & Aesthetic Surgery, vol. 65, no. 1, pp. 68–71, 2012.
[78]
A. T. Lyos, G. R. D. Evans, D. Perez, and M. A. Schusterman, “Tongue reconstruction: outcomes with the rectus abdominis flap,” Plastic and Reconstructive Surgery, vol. 103, no. 2, pp. 442–447, 1999.
[79]
Y. Kimata, M. Sakuraba, S. Hishinuma et al., “Analysis of the relations between the shape of the reconstructed tongue and postoperative functions after subtotal or total glossectomy,” Laryngoscope, vol. 113, no. 5, pp. 905–909, 2003.
[80]
Y. Yamamoto, T. Sugihara, Y. Furuta, and S. Fukuda, “Functional reconstruction of the tongue and deglutition muscles following extensive resection of tongue cancer,” Plastic and Reconstructive Surgery, vol. 102, no. 4, pp. 993–998, 1998.
[81]
P. Yu, “Reinnervated anterolateral thigh flap for tongue reconstruction,” Head and Neck, vol. 26, no. 12, pp. 1038–1044, 2004.
[82]
E. Santamaria, F. C. Wei, I. H. Chen, and D. C. C. Chuang, “Sensation recovery on innervated radial forearm flap for hemiglossectomy reconstruction by using different recipient nerves,” Plastic and Reconstructive Surgery, vol. 103, no. 2, pp. 450–457, 1999.
[83]
M. L. Shindo, U. K. Sinha, and D. H. Rice, “Sensory recovery in noninnervated free flaps for head and neck reconstruction,” Laryngoscope, vol. 105, no. 12, pp. 1290–1293, 1995.
[84]
J. P. M. Vriens, R. Acosta, D. S. Soutar, and M. H. C. Webster, “Recovery of sensation in the radial forearm free flap in oral reconstruction,” Plastic and Reconstructive Surgery, vol. 98, no. 4, pp. 649–656, 1996.
[85]
Y. Kimata, K. Uchiyama, S. Ebihara et al., “Comparison of innervated and noninnervated free flaps in oral reconstruction,” Plastic and Reconstructive Surgery, vol. 104, no. 5, pp. 1307–1313, 1999.
[86]
M. E. Zafereo, R. S. Weber, J. S. Lewin, D. B. Roberts, and M. M. Hanasono, “Complications and functional outcomes following complex oropharyngeal reconstruction,” Head and Neck, vol. 32, no. 8, pp. 1003–1011, 2010.
[87]
J. J. Disa, A. L. Pusic, D. A. Hidalgo, and P. G. Cordeiro, “Microvascular reconstruction of the hypopharynx: defect classification, treatment algorithm, and functional outcome based on 165 consecutive cases,” Plastic and Reconstructive Surgery, vol. 111, no. 2, pp. 652–660, 2003.
[88]
J. J. Coleman, J. M. Searles, T. R. Hester et al., “Ten years experience with the free jejunal autograft,” The American Journal of Surgery, vol. 154, no. 4, pp. 389–393, 1987.
[89]
J. J. Coleman III, K.-C. Tan, J. M. Searles, T. R. Hester, and F. Nahai, “Jejunal free autograft: analysis of complications and their resolution,” Plastic and Reconstructive Surgery, vol. 84, no. 4, pp. 589–595, 1989.
[90]
M. A. Schusterman, K. Shestak, E. J. de Vries et al., “Reconstruction of the cervical esophagus: free jejunal transfer versus gastric pull-up,” Plastic and Reconstructive Surgery, vol. 85, no. 1, pp. 16–21, 1990.
[91]
G. P. Reece, M. A. Schusterman, M. J. Miller et al., “Morbidity and functional outcome of free jejunal transfer reconstruction for circumferential defects of the pharynx and cervical esophagus,” Plastic and Reconstructive Surgery, vol. 96, no. 6, pp. 1307–1316, 1995.
[92]
P. Yu, “Characteristics of the anterolateral thigh flap in a western population and its application in head and neck reconstruction,” Head and Neck, vol. 26, no. 9, pp. 759–769, 2004.
[93]
P. Yu and G. L. Robb, “Pharyngoesophageal reconstruction with the anterolateral thigh flap: a clinical and functional outcomes study,” Plastic and Reconstructive Surgery, vol. 116, no. 7, pp. 1845–1855, 2005.
[94]
E. M. Genden and A. S. Jacobson, “The role of the anterolateral thigh flap for pharyngoesophageal reconstruction,” Archives of Otolaryngology—Head & Neck Surgery, vol. 131, no. 9, pp. 796–799, 2005.
[95]
P. Yu, J. S. Lewin, G. P. Reece, and G. L. Robb, “Comparison of clinical and functional outcomes and hospital costs following pharyngoesophageal reconstruction with the anterolateral thigh free flap versus the jejunal flap,” Plastic and Reconstructive Surgery, vol. 117, no. 3, pp. 968–974, 2006.
[96]
D. J. Murray, R. W. Gilbert, M. J. J. Vesely et al., “Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube,” Head and Neck, vol. 29, no. 2, pp. 147–154, 2007.
[97]
P. Yu, M. M. Hanasono, R. J. Skoracki et al., “Pharyngoesophageal reconstruction with the anterolateral thigh flap after total laryngopharyngectomy,” Cancer, vol. 116, no. 7, pp. 1718–1724, 2010.
[98]
B. Azizzadeh, S. Yafai, J. D. Rawnsley et al., “Radial forearm free flap pharyngoesophageal reconstruction,” Laryngoscope, vol. 111, no. 5, pp. 807–810, 2001.
[99]
J. Scharpf and R. M. Esclamado, “Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer,” Head and Neck, vol. 25, no. 4, pp. 261–266, 2003.
[100]
D. W. Chang, C. Hussussian, J. S. Lewin, A. A. Youssef, G. L. Robb, and G. P. Reece, “Analysis of pharyngocutaneous fistula following free jejunal transfer for total laryngopharyngectomy,” Plastic and Reconstructive Surgery, vol. 109, no. 5, pp. 1522–1527, 2002.
[101]
P. Yu, “One-stage reconstruction of complex pharyngoesophageal, tracheal, and anterior neck defects,” Plastic and Reconstructive Surgery, vol. 116, no. 4, pp. 949–956, 2005.
[102]
M. K. Wax, “The role of the implantable Doppler probe in free flap surgery,” The Laryngoscope, vol. 124, supplement 1, pp. S1–S12, 2014.
[103]
R. E. H. Ferguson and P. Yu, “Techniques of monitoring buried fasciocutaneous free flaps,” Plastic and Reconstructive Surgery, vol. 123, no. 2, pp. 525–532, 2009.
