title: Surgical strategies based on standard templates for microsurgical reconstruction of oral cavity and oropharynx soft tissue: a 20 years' experience.
abstract: BACKGROUND
  Microsurgical reconstruction has become the worldwide gold standard for repairing surgical defects in head and neck cancer. The aim of this article is to describe a standardized reconstructive approach to the oral cavity and oropharynx soft tissue defects.
  
  
  METHODS
  Since 1992, the authors have treated 163 patients affected by oral cavity and oropharynx cancer, performing a total of 175 flaps. A systematic postoperative functional study prompted a surgical strategy, in terms of flap choice, shape, and insetting. A two-dimensional template was used to obtain a three-dimensional reconstruction for the best functional and aesthetic outcome. To simplify preoperative planning, surgical resections were divided into a set number of classes. The templates, flap choice, and insetting are described for each region.
  
  
  RESULTS
  Complications consisted of seven partial necroses of the flap which easily resolved with a local toilette and 12 complete necroses of the flap due to vascular thrombosis, these patients required a secondary reconstruction with another free flap. Functional results were systematically evaluated in the first 60 patients of our series with particular attention to the swallowing function, which was analyzed by both videofluoroscopy and functional endoscopic evaluation of swallowing. Results showed a good functional recovery with the described reconstructive techniques.
  
  
  CONCLUSIONS
  A standardized surgical strategy based on reproducible templates might facilitate less experienced surgeons in analyzing the problem, choosing the best technical solution and foreseeing the functional outcomes.
authors: ENT Department, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors: Umberto
authors: U
authors: Caliceti
authors: Ottavio
authors: O
authors: Piccin
authors: Rossella
authors: R
authors: Sgarzani
authors: Luca
authors: L
authors: Negosanti
authors: Ignacio Javier
authors: IJ
authors: Fernandez
authors: Aurel
authors: A
authors: Nebiaj
authors: Federico
authors: F
authors: Contedini
authors: Riccardo
authors: R
authors: Cipriani
authors: Alberto Rinaldi
authors: AR
authors: Ceroni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D005260:Female; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009055:Mouth / Q000473:pathology / Q000601:surgery*; D009960:Oropharynx / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome