title: Reconstruction of complex defects of the parotid region using a lateral thoracic wall donor site.
abstract: Radical treatment of parotid neoplasms may lead to complex parotid defects that present functional and aesthetic reconstructive challenges. We report our experience using the lateral thoracic wall as a single donor site. Between 2003 and 2009, four patients with malignant tumours in the parotid gland underwent radical parotidectomy and simultaneous reconstruction using a perforator latissimus dorsi cutaneous free flap (de-epithelialized and entire skin paddle in two cases each). A thoracodorsal nerve graft was used in all cases to replace the intraglandular branches of the facial nerve. Costal grafts were used for mandibular reconstruction in two patients. All patients underwent postoperative physiotherapy. No donor-site complication occurred and all treatments achieved good aesthetic results. All patients recovered nearly complete symmetry at rest and partial facial mimetic function. The lateral thoracic wall is a good donor site for the reconstruction of complex parotid defects.
authors.affiliation: Department of Maxillo-Facial Surgery (Head Prof. F. Biglioli), San Paolo Hospital, University of Milano, Via A di Rudinì 8, 20142 Milano, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
authors.forename: Marco
authors.initials: M
authors.lastname: Pedrazzoli
authors.forename: Dimitri
authors.initials: D
authors.lastname: Rabbiosi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Colletti
authors.forename: Valeria
authors.initials: V
authors.lastname: Colombo
authors.forename: Alice
authors.initials: A
authors.lastname: Frigerio
authors.forename: Luca
authors.initials: L
authors.lastname: Autelitano
mesh_terms: D000368:Aged; D016025:Bone Transplantation / Q000379:methods; D004954:Esthetics; D005152:Facial Muscles / Q000294:innervation / Q000502:physiology; D005154:Facial Nerve / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction / Q000379:methods; D018482:Muscle, Skeletal / Q000637:transplantation; D037981:Neck Dissection; D010307:Parotid Neoplasms / Q000601:surgery*; D010525:Peripheral Nerves / Q000637:transplantation; D026741:Physical Therapy Modalities; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000637:transplantation; D016038:Skin Transplantation / Q000379:methods; D015996:Survival Rate; D035441:Thoracic Wall / Q000637:transplantation*; D060053:Transplant Donor Site / Q000601:surgery*; D016896:Treatment Outcome