The Application Of Pedicle Tissue Flap In Reconstruction Of Head And Neck

ObjectiveTo discuss and evaluate the application and outcomes of pedicle tissue fla p in reconstruction of head and neck surgery.Material and MethodRetrospective analysis 941 operations of patients with benign or malignant diseases in Otolaryngology Department of Qilu Hospital of ShanDong Universi ty.The patients underwent reconstruction of defects using pectoralis myocutaneo us flap,sternohyoid flap,thyrohyoid flap,epiglottis flap,the tongue flap,precervicle skin flap,masculo-periosteum flap of sternocleidomastoid,laryngotrocheal flap,ph aryngo-gastric anastomosis and pharyngo-colonic anastomosis.Result925 patients suffered from malignant diseases.Among them,693 patients ha d laryngeal cancer.284 in stage Ⅰ,235 in stage Ⅱ,112 in stage Ⅲ,30 in stage IVA.25 patients had regional recurrency and 7 patients had cervical metastasis in lymphonodes.158 patients had hypopharyngeal cancer.1 in stage Ⅱ,11 in stage 111,125 in stage IVA,10 in stage ⅣB.5 patients had regional recurrency and 6 patients had cervical metastasis in lymphonodes.11 patients had thyroid cancer. 6 out of them had papillary thyroid cancer,3 in stage ⅣA,3 in stage ⅣB.1 patient had low differentiated thyroid cancer and 2 had undifferentiated thyroid cancer.1 patients had squamous-cell carcinoma in thyoid gland.2 patients had to nsillar cancer in stage IVA.7 patients had cancer of tongue root.2 in stage Ⅲ a nd 5 in stage ⅣA.37 patients had cervical esophageal cancer.3 in stage IB,15 in stage ⅡA,8 in stage ⅡB,10 in stage ⅡA and 1 in stage ⅢB.17patients had pharygo-cutaneous fistula.16 patients suffered from benign diseases,of which w ere 15 with laryngeal stenosis and 1 with hypopharyngeal stenosis.143 out of 146 patients underwent reconstruction with pectoralis major fla p in single or in combination had their swollowing function recovered.The dec annulation rate of 558 patients underwent sternohyoid flap reconstruction in sin gle or in combination is 85.6%.The decannulation rate of 43 patients underwen t reconstruction with thyrohyoid flap in single of in combination is 92%.The d ecannulation rate of 45 patient underwent reconstruction with epiglottis flap is 90%.2 patient underwent reconstruction with tongue flap combined with laryngo-tracheal flap and PMMF had their swollowing function recoverd.The 3 patient underwent reconstruction with masculo-periosteum flap of sternocleidomastoid i n single or in combination had.38 out of 40 patients underwent reconstruction with laryngo-tracheal flap had their swollowing function recovered.55 out of 58 patients underwent reconstuction with pharyngo-gastric anastomosis in single o r in combination had their swollowing function recovered and the reservation r ate of larynx funcion is 53.4%.13 out 15 patients underwent reconstuction with pharyngo-colonic anastomosis in single or in combination had their swollowin g function recovered and the reservation rate of larynx funcion is 93.3%.ConclusionPedicled tissus flap meets the requirement of reconstruction in head and n eck surgery because the flap has the advantages of good blood supply, mature technology,easy operation and requiring less operation skill.It play an important role in I stage reconstuction of head and neck surgery when used flexibilly.