The new technique offers a safer option for head and neck reconstruction

Sometimes, moving just a few inches can go a long way.

Osaka Metropolitan University researchers have developed a promising technique for head and neck reconstruction that shifts the placement of transplanted tissue with attached blood vessels, offering a safer and faster option for patients with complex tissue defects, especially those at high risk .

Head and neck reconstruction plays a key role in the treatment of patients with head and neck cancer. The goal is to preserve the vital functions of breathing, eating and speaking while preserving the patient’s appearance and quality of life.

“Traditional reconstruction typically uses free flaps, which may not be feasible for some patients, such as those who have had prior radiation therapy or multiple surgeries.”

Tsubasa Kojima, a physician and lecturer at the Osaka Metropolitan University Graduate School of Medicine and lead author of the study

A free flap is a piece of tissue that is completely detached from a healthy part of the body (donor site) and reattached to new blood vessels in the defect (recipient site).

The research team blazed a new trail and instead worked with pedicle flaps taken from the back, called latissimus dorsi pedicle (LD) myodermal flaps. Unlike free flaps, pedicled flaps remain partially attached to the donor site, maintaining their natural blood supply as they are transported to the recipient site for reconstruction.

While the LD flap has been used in a variety of reconstructive procedures, the team developed a unique approach that placed the skin portion of the LD flap farther, or lower, on the back than with conventional techniques. This design includes the lateral cutaneous branch of the 10^u posterior intercostal artery, ensuring reliable blood flow to the flap.

“This setup provides flexibility, allowing the LD flap to cover extensive defects, including those in the mouth and neck simultaneously, and even facilitates jaw reconstruction by incorporating rib bone,” Kojima said.

The study, conducted between 2003 and 2024, showed that the pedicled LD flap was successfully incorporated in all 22 patients with complex head and neck defects.

“Our results suggest that this LD flap technique provides a reliable, rapid, and minimally invasive option for head and neck reconstruction, particularly in cases where free flaps are not appropriate,” Kojima said. “We hope this approach will significantly improve treatment outcomes for patients undergoing head and neck reconstruction.”

Their findings were published in Plastic and Reconstructive Surgery—Open Worldwide.