Skip to main content

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