Free Flap Reconstruction for Head and Neck Cancer Defects: A Systematic Review of Outcomes and Complications

Abstract

Introduction: The resection of head and neck cancers often leaves complex defects that require sophisticated reconstruction to restore form and function. Microvascular free flap transfer is the gold standard for this purpose. This review summarizes the outcomes of this technique.

Methods: A systematic review of large institutional cohort studies of free flap reconstruction for head and neck defects was performed. Primary outcomes were the rates of flap success, major complications (e.g., flap failure, fistula), and functional outcomes (e.g., speech, swallowing).

Results: The analysis of over 100 studies showed that in high-volume centers, the success rate of free flap transfer is consistently above 95%. The most common flaps used were the radial forearm flap for soft tissue and the fibula free flap for mandible reconstruction. Functional outcomes were generally good, allowing for the restoration of essential functions.

Discussion: Free flap reconstruction is a reliable and versatile technique that is essential to modern head and neck oncologic surgery. Success is highly dependent on surgeon experience and institutional resources.

Conclusion: Microvascular free flap transfer is a safe and reliable method for reconstructing complex head and neck defects with high success rates.