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Cirugía Plástica Ibero-Latinoamericana

versión On-line ISSN 1989-2055versión impresa ISSN 0376-7892

Resumen

BOLEA, Esteban et al. Free flap reconstruction after resection of head and neck sarcomas. Cir. plást. iberolatinoam. [online]. 2020, vol.46, n.1, pp.45-52.  Epub 25-Mayo-2020. ISSN 1989-2055.  http://dx.doi.org/10.4321/s0376-78922020000100007.

Background and objective

Head and neck sarcomas are an unfrequent group of tumors. Since surgical resection is the op timal treatment modality, problems of functional and aesthetic nature arise as important challenges.

The aim of this study was to describe our outcome in a series of patients with free flap reconstruction after resection of head and neck sarcomas.

Methods

We conduct a retrospective review of clinical re cords of patients operated on between October 2015 and January 2018. Four adult patients primary treated for sarcomas were se lected: 3woman and 1 man, ages ranged between 25 and 62 years old.Two cases presented pleomorphic sarcoma of the orbit and 2 cases spindle cell sarcoma and osteosarcoma of the jaw.

Results

All the patients underwent complete surgical re section with satisfactory margins. Free flaps could be harvested during tumor resection. In case 1 a vertical rectus abdominus myocutanous free flap was performed, and in case 2 an anterola teral thigh free flap. In both patients these flaps allowed adequate soft tissue coverage without donor site morbidity and early dis charge. In cases 3 and 4 with sarcoma in the jaw, an extended cen tral defect of the mandible and floor of the mouth was produced, and reconstruction was undertaken with an osteo-cutaneous fi bula free flap. Both patients presented small orocutaneous fistula that were managed with conservative treatment.

Conclusions

When sarcomas occur in young and otherwi se healthy patients, extensive resections can be undertaken and reconstruction with free flaps is an appropriate option, as they proved to be safe, reliable and versatile in our own experience, with minimal donor site morbidity.

Palabras clave : Head and neck cancer; Sarcoma; Microsurgical free flap; Head and neck reconstruction.

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