Use of the keystone island flap for advanced head and neck cancer in the elderly – a principle of amelioration

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 63; no. 5; pp. 739 - 745
• Main Authors: Behan, Felix, Sizeland, Andrew, Gilmour, Fraser, Hui, Andrew, Seel, Matthew, Lo, Cheng Hean
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.05.2010; Elsevier
• Subjects: Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Cancer; Elderly; Female; Follow-Up Studies; Head and neck; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - surgery; Humans; Keystone island flap; Male; Medical sciences; Neck Dissection - methods; Neoplasm Staging; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Plastic Surgery; Reconstructive Surgical Procedures - methods; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgical Flaps; Time Factors; Treatment Outcome; Tumors; Head and neck; Keystone island flap; Elderly; Cancer; Human; Treatment; Surgery; ENT disease; Head and neck cancer; Island flap; Malignant tumor
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2009.01.079

Summary Traditional management strategies of advanced head and neck cancer in the elderly include palliation and radical resection with microsurgical reconstruction. The keystone flap approach is an alternate reconstructive technique with a range of benefits for the aging population. This publication presents a series of elderly patients with head and neck cancer who underwent resection and reconstruction using the keystone flap principles. The aim is to demonstrate the value of this reconstructive technique in the various anatomical regions of the head and neck. Various operative sequences are accompanied by illustrations and discussions of the underlying principles.