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Clinical Challenges in Otolaryngology
July 2000

All Patients Should Be Considered Possible Candidates for Reconstruction With Free Flaps

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2000;126(7):913. doi:10.1001/archotol.126.7.913

As myocutaneous flaps revolutionized head and neck reconstruction in the 1980s, so did free flaps in the 1990s. The quality of reconstructions that match tissue types and contour using free flaps vastly exceeds that of the amorphous blobs we were saddled with using only pedicled muscle flaps. Despite these advances, however, myocutaneous flaps still play an important role in reconstruction—especially in salvage or higher-risk cases. For instance, a pectoralis flap in a patient with a partial hypopharyngeal and/or laryngectomy defect has very little increased morbidity because of loss of the muscle, and failure of a pectoralis flap is a rare event indeed.

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