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 |