Abstract
Microsurgical free flaps are the accepted standard of care for head and neck reconstruction after tumor resection. In many cases, the pedicle of the free flap needs to be tunneled under bone and/or soft tissues to reach the recipient vessels in the site of anastomosis, most often located in the neck. Passing the pedicle through the dissected tunnel is always a blind procedure that increases the risk of shearing, turning, twisting, or kinking and in the worst case disconnection. We hereby demonstrate a novel and simple technique for a safe delivery of the pedicle to the anastomosis site in the neck using a nasopharyngeal airway (nasal airway) connected to negative pressure suction. In all of our cases, no complications were noted during the pedicle delivery to the neck while using this method.
Level of Evidence: Level IV, therapeutic study.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lo SL, Yen YH, Lee PJ, Liu CC, Pu CM (2017) Factors influencing postoperative complications in reconstructive microsurgery for head and neck cancer. J Oral Maxillofac Surg 75(4):867–873
Wong CH, Wei FC (2010) Microsurgical free flap in head and neck reconstruction. Head Neck 32(9):1236–1245
Moschella F, D’Arpa S, Di Lorenzo S, Cordova A (2010) Safe pedicle tunnelling in maxillary reconstruction. J Plast Reconstr Aesthet Surg 63(3):e289
Aggarwal A, Singh H, Mahendru S, Brajesh V, Singh S, Khare A, Khazanchi RK (2015) Pedicle streaking: a novel and simple aid in pedicle positioning in free tissue transfer. Indian J Plast Surg 48(3):274–277
Hamamoto Y, Nagasao T, Ensako T, Tanaka Y (2015) Segmental marking: a new technique to prevent pedicle twisting. J Plast Reconstr Aesthet Surg 68(6):873–874
Cascarini L, Monteiro MJ, Collard BR, Lyons AJ (2008) Simple technique to prevent twisting of the perforating vessels in an anterolateral thigh flap. Br J Oral Maxillofac Surg 46(8):694–695
Chen HC, Tang YB (2003) Anterolateral thigh flap: an ideal soft tissue flap. Clin Plast Surg 30(3):383–401
Zheng L, Li N, Jiang C, Guo F (2015) Novel technique to avoid twisting of the perforator and main pedicle in the anterolateral thigh flap. Br J Oral Maxillofac Surg 53(3):305–306
Yadav PS, Ahmad QG, Shankhdhar VK, Nambi GI (2010) Pedicle transfer in oral cavity reconstruction. Indian J Plast Surg 43(1):79–80
Panayi AC, Leavitt T, Orgill DP (2017) Evidence based review of negative pressure wound therapy. World J Dermatol 6(1):1–16
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
None
Conflict of interest
Shay Tamir MD, Har-Shai Lior MD, Ad-El Dean D. MD, and Amir Aharon MD declare that they have no conflict of interest.
Ethical approval
Not applicable.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Shay, T., Har-Shai, L., Ad-El, D.D. et al. A novel technique for the safe transfer of the pedicle of a free flap in head and neck reconstruction using a nasopharyngeal airway connected to a negative pressure suction. Eur J Plast Surg 42, 505–508 (2019). https://doi.org/10.1007/s00238-019-01524-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-019-01524-y