Table 11 Defect algorithm Oral cavity
From: Complex reconstructions in head and neck cancer surgery: decision making
| Soft tissue defect | |
|---|---|
| Floor of mouth | - Radial forearm flap |
| - Lateral arm flap | |
| - TAP | |
| - Alt | |
| Tongue | - ALT |
| - Radial forearm flap | |
| - Lateral arm flap | |
| - TAP | |
| Palate | - Radial forearm flap |
| - Lateral arm flap | |
| - TAP | |
| - ALT | |
| Bone Defect | |
| Mandible/Palate | - Fibula osteocutaneous flap (up to 25 cm bone) |
| - Iliac crest flap (14-16 cm bone) | |
| - Radial forearm osteocutaneous flap (30% radius circumference) | |
| - Scapular osteocutaneous flap (up to 10 cm bone) | |
| Hypopharynx | |
| Partial defect | - Radial forearm flap |
| - Lateral arm Flap | |
| - TAP | |
| - ALT (strongly recommended when external skin coverage is necessary- wrap flap) | |
| - Latissimus dorsi muscle | |
| Circumferential defect | - ALT (wrap to build a tube) |
| - Jejunum | |
| - Latissimus dorsi muscle | |
| - TRAM/DIEP | |
| Defects creating dead space | - Rectus abdominis muscle |
| - ALT with vastus lateralis | |