Am J Otolaryngol Head Neck Surg | Volume 6, Issue 7 | Review Article | Open Access

Pedicled Latissimus Flap for Scalp Defects - A Reliable Yet Less Used Reconstructive Option for Large Scalp, Temporal and Head and Neck Defects - Review of the Technique, Indications, Utility and Outcomes

Shenoy AM^1*, Sethiya A² and Shitole A²

¹Department of Head and Neck Surgical Oncology, Kokilaben Dhirubai Ambani Hospital, India ²Department of Plastic & Reconstructive Surgery, Kokilaben Dhirubai Ambani Hospital, India

^*Correspondance to: Ashok M Shenoy, 

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Abstract

Latissimus dorsi flap despite being a reliable and robust reconstructive option has found less than desirable mention in the reconstruction of defects following head and neck, scalp and skull base resections. While free flaps are used regularly following ablative defects there are issues related to the need for special microvascular expertise, financial constraints and additional morbidity that have not led to their universal acceptance for resurfacing defects after major resections of the scalp and head and neck region. Most cancer centers do not have access to sophisticated microvascular surgical infrastructure and therefore utilize Pectoralis Major Myocutaneous Flap (PMMF) commonly. Little do surgeons realize that PMMF are associated with serious morbidity affecting the shoulder joint and mutilation of breast which is resented by the female patient. The Pedicled Latissimus Dorsi Flap (PLDF) is a relatively under used alternative reconstructive option which if used judiciously may minimize the shoulder joint disability considerably and aid in the post-surgical rehabilitation. The only perceived limitation has been the need for patient repositioning to harvest the flap from lower back which in the past led to additional time during the surgical procedure. With regard to reconstruction of scalp defects, intubation is usually achieved in an operating trolley with patient in supine position and then the patient is shifted onto a prone position on the OR table with a special neurosurgical head holder that allows the endotracheal tube to exit below the head end of table without any kinking or obstruction to link with the adaptor that connects it to the ventilating anesthetic machine.

Citation:

Shenoy AM, Sethiya A, Shitole A. Pedicled Latissimus Flap for Scalp Defects - A Reliable Yet Less Used Reconstructive Option for Large Scalp, Temporal and Head and Neck Defects - Review of the Technique, Indications, Utility and Outcomes. Am J Otolaryngol Head Neck Surg. 2023;6(7):1253..