The folded double paddled free flaps for head and neck reconstruction

We report our experience in the reconstruction of the full thickness defects of oral cavity and pharyngo-eosephageal region after wide surgical cancer ablation using different free flaps during the past ten years. 22 radial forearm flaps, six latissimus dorsi flaps and three rectos abdominis flaps were used in bipaddled fashion for full thickness defects of the cheek, floor of the mouth, maxillectomy and pharyngostoma defects resulting from cancer resection. The flaps provided both intraoral lining and skin cover in all cases. All the flaps survived, in one latissimus dorsi transfer a partial skin necrosis occurred in the distal paddle. No major complication were observed, salivary fistula developed in six cases which healed spontaneously up to four weeks postoperatively. The patients started oral feeding around three weeks postoperatively. Double paddled free flap reconstruction of oral cavity has many advantages. It is a one stage reconstruction, patient recovery is shorter and quality of life of the patient is better.