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Inicio Acta Otorrinolaringológica Española Gracilis free flap in head and neck reconstruction beyond facial palsy reanimati...
Journal Information
Vol. 73. Issue 5.
Pages 310-322 (September - October 2022)
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Vol. 73. Issue 5.
Pages 310-322 (September - October 2022)
Review article
Gracilis free flap in head and neck reconstruction beyond facial palsy reanimation
Colgajo libre de gracilis en cirugía reconstructiva de cabeza y cuello, más allá de la reanimación de parálisis facial
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Carlos Miguel Chiesa-Estombaa,i,
Corresponding author
chiesaestomba86@gmail.com

Corresponding author.
, José Ángel González-Garcíaa, Cesare Piazzab, Miguel Mayo-Yanezc,i, Alberto Grammaticad, Jerome R. Lechiene,i, Taseer F. Dinf, Petros Karkosg, Leire García-Izaa, Tareck Ayadh,i
a Otorhinolaryngology – Head & Neck Surgery Department, Hospital Universitario Donostia, San Sebastian, Guipuzkoa – Basque Country, Spain
b Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy
c Otorhinolaryngology – Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), 15006 A Coruña, Galicia, Spain
d Department of Otorhinolaryngology – Head and Neck Surgery, University of Brescia, Brescia, Italy
e Department of Human Anatomy & Experimental Oncology, University of Mons, Mons, Belgium
f Division of Otolaryngology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
g Department of Otolaryngology – Head Neck Surgery, Ahepa University Hospital, Thessaloniki, Greece
h Division of Otolaryngology – Head & Neck Surgery, Centre Hospitalier de l’Université de Montréal, Montreal, Canada
i Head & Neck Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France
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Abstract
Introduction

The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular component, and possibility to perform nerve coaptation. However, almost all the existing evidence in the literature is related to its use for facial palsy reanimation. The aim of this study was therefore to review and provide a comprehensive summary of all the possible indications and outcomes of this versatile free flap in head neck reconstructive surgery.

Materials and methods

A systematic review of the literature was conducted including articles from 1970 to 2019. All articles were examined and described.

Results

Twenty-seven papers published between 1994 and 2019 were identified for analysis. The evidence highlights the use of the gracilis muscle free flap for parotid, forehead and midface defects, oral tongue, oral sphincter, lower and upper lip, cheek, and oral commissure defects, among others, as the most common defects reconstructed.

Conclusion

This flap represents an easy to harvest and versatile free flap with low donor-site morbidity and multiple proven uses in head & neck reconstruction. We therefore encourage reconstructive surgeons to include this flap in their armoury, either as a first or as a second-line option.

Keywords:
Gracilis
Free flap
Head & neck reconstruction
Resumen
Introducción

El colgajo libre de músculo gracilis ha ganado popularidad en la reconstrucción de cabeza y cuello debido a una mínima morbilidad en el sitio donante, un pedículo vascular confiable, un componente muscular fuerte y la posibilidad de realizar una coaptación nerviosa. Sin embargo, casi toda la evidencia existente en la literatura está relacionada con su uso para la reanimación de la parálisis facial. El objetivo de este estudio fue, por tanto, revisar y proporcionar un resumen completo de todas las posibles indicaciones y resultados de este versátil colgajo libre en cirugía reconstructiva de cabeza y cuello.

Materiales y métodos

Se realizó una revisión sistemática de la literatura incluyendo artículos de 1970 a 2019. Todos fueron examinados y descritos.

Resultados

Se identificaron 27 artículos publicados entre 1994 y 2019 para su análisis. La evidencia destaca el uso del colgajo libre de músculo gracilis para defectos de parótida, frente y región medio facial, lengua oral, esfínter oral, labio inferior y superior, defectos de mejilla y comisura oral, como los defectos reconstruidos más comunes.

Conclusión

Este colgajo representa un colgajo libre versátil y fácil de elevar con baja morbilidad a nivel del sitio donante y múltiples posibilidades en la reconstrucción de cabeza y cuello. Por lo tanto, representa una herramienta útil en el arsenal reconstructivo de cualquier cirujano, ya sea como una opción de primera o de segunda línea.

Palabras clave:
Gracilis
Colgajo libre
Reconstrucción de cabeza y cuello

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