Researchers have developed a new head and neck reconstruction technique that achieves a 100% success rate in 22 cases with complex defects.
They suggest a pedicled latissimus dorsi flap offers a safer, faster alternative for high-risk patients.
Researchers at Japan’s Osaka Metropolitan University developed the new technique, shifting the placement of transferred tissue with blood vessels attached.
Lead author Tsubasa Kojima, a medical doctor and lecturer at the university’s Graduate School of Medicine, explained: ‘Traditional reconstruction typically uses free flaps, which may not be feasible for some patients, such as those who have had prior radiation treatment or multiple surgeries.’
The research team worked with pedicled flaps taken from the back, called pedicled latissimus dorsi (LD) myocutaneous flaps.
Unlike free flaps, pedicled flaps remain partially attached to the donor site, retaining their natural blood supply as they are transferred to the recipient site for reconstruction.
While the LD flap has been used in various reconstructive surgeries, the team developed this unique approach that places the skin portion of the LD flap more distally, or lower on the back, than in conventional techniques.
This design includes the lateral cutaneous branch of the 10th posterior intercostal artery, ensuring reliable blood flow to the flap.
Kojima added: ‘This setup provides flexibility, allowing the LD flap to cover extensive defects, including those in both the mouth and neck simultaneously, and even facilitates jaw reconstruction by incorporating rib bone.’
The study, conducted between 2003 and 2024, demonstrated that the pedicled LD flap was successfully integrated in all 22 patients with complex head and neck defects.
The author added: ‘Our results suggest that this pedicled LD flap technique provides a reliable, fast and minimally invasive option for head and neck reconstruction, particularly in cases where free flaps are not suitable. We hope this approach will significantly improve treatment outcomes for patients undergoing head and neck reconstruction.’
