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Sternocleidomastoid musculocutaneous flaps have been described in the literature for reconstruction of oral cavity defects and treatment of Frey's syndrome. Although widely studied, it is not used routinely in head and neck reconstruction due to limitations like small size, unreliable skin paddle, contour deformity in the neck and the question of oncologic safety. We report use of perforator based musculocutaneous transposition flap for defect over nape of the neck, followed by excision of a soft tissue sarcoma. This constitutes a valid alternative to other reconstructive procedures like pedicled regional flaps or free tissue transfer in a suitable group of patients.

Background: Reconstruction with microvascular free flaps is considered the reconstructive option of choice in cancer of the head and neck regions and breast. Rarely, there is paucity of vessels, especially the veins, at the recipient site. The cephalic vein with its good caliber and constant anatomy is a reliable recipient vein available in such situations. Materials and Methods: It is a retrospective study from January 2010 to July 2012 and includes 26 patients in whom cephalic vein was used for free-flap reconstruction in head and neck (3 cases) and breast cancers (23 cases). Results: All flaps in which cephalic vein was used survived completely. Conclusion: Cephalic vein can be considered as a reliable source of venous drainage when there is a non-availability/ unusable of veins during free-flap reconstruction in the head and neck region and breast and also when additional source of venous drainage is required in these cases. [ABSTRACT FROM AUTHOR]

In the past two decades, the advancement in the microsurgical techniques has revolutionised the reconstruction of post-oncological head and neck defects. Free fibula osteocutaneous flap (FFOCF) has been considered as the treatment of choice by many for mandible reconstruction. The improvement in the surgical resection and adjuvant treatment has improved the survival rates even in patients with advanced cancer. Simultaneously the reconstruction is addressed towards more functional and aesthetic aspects to improve the quality of life in these patients. In this respect, a double free flap is advocated in certain cases of extensive composite oromandibular defects (COMDs). But in our institute, we have managed two such cases of extensive COMD with a single FFOCF unit - fibula bone with a skin paddle for inner lining and a perforator-based skin paddle from the proximal part of the FFOCF unit, anastomosed separately for outer cover. Compared to two separate free flaps, this method has the advantage of single donor site and reduction in reconstruction time. Though the technique of divided paddle, deepithelisation and supercharging has been mentioned for FFOCF, no such clinical cases of two free flaps from a single FFOCF unit have been mentioned in the literature. [ABSTRACT FROM AUTHOR]

The article discusses the variation of superficial radial nerve. It highlights the free radial artery forearm flap (FRAFF) which is one of the most common flaps initiated by surgeons during the reconstruction's initial phase. The impact of harvesting the nerve with the flap in losing the sensory of the hands is also emphasized.