Experience of head and neck free flap reconstruction in children

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Abstract

From 2015 to 2017, 14 surgical intervention for benign and malignant tumors of mandibular and maxillary regions, soft tissues in the temporal areas and extra organ soft tissue tumors of the head have been performed in the Department of Oncology and Pediatric Surgery of Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology (Moscow). Simultaneous or delayed reconstructions were performed with a bone-muscle flap taken from the crista iliaca, with a fibular flap or a soft tissue radial flap. In all cases, the anastomoses were well-fixed and the flaps viable. The paper presents a clinical case of a 6-year old girl with a central gigantic cell granuloma of the mandibular body. The tumor was resected with a simultaneous reconstruction with a free fibular flap based on stereolythographic resection templates. By the time this paper was written, the duration of the follow-up exceeded 1.5 years. There is no relapse, the free flap is well-fixed and functional, and the child is socially adapted. Based on the radical resection of the primary tumor, preserved innervations of the chin soft tissues, full facial mimics and rapid social adaptation of the child, as well as functional preservation of the jaw and the possibility of oral nutrition, together with the possibility of prosthodontics in the post-operative period, we consider this treatment approach to be optimal for this case. The use of free flaps was highly optimal in all other cases as well, due to their advantages, such as highly radical resection, good functional and esthetic results, rapid social adaptation of children. We believe that wider indications for reconstruction with free flaps are very promising in pediatric practice. 

About the authors

N. S. Grachev

Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology

Email: fake@neicon.ru

Grachev Nikolay S. – MD, PhD, Head of Department of Oncology and Pediatric Surgery 

1 Samory Mashela ul., Moscow, 117997

Russian Federation

S. V. Tereshchuk

Burdenko Main Military Clinical Hospital

Email: fake@neicon.ru

Tereshchuk Sergey V. – MD, Head of Center for Maxillofacial Surgery, Chief Stomatologist of the Hospital  

3 Gospital'naya ploshchad', Moscow, 105229

Russian Federation

N. V. Babaskina

Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology

Author for correspondence.
Email: nbabaskina@bk.ru

Babaskina Natal'ya V. – MD, Oncologist, Department of Oncology and Pediatric Surgery 

1 Samory Mashela ul., Moscow, 117997

Russian Federation

I. N. Vorozhtsov

Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology

Email: fake@neicon.ru

Vorozhtsov Igor N. – Research Fellow, Department of Head and Neck Surgery and Reconstructive Plastic Surgery 

1 Samory Mashela ul., Moscow, 117997

Russian Federation

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Copyright (c) 2017 Grachev N.S., Tereshchuk S.V., Babaskina N.V., Vorozhtsov I.N.

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