The evolving role of free flaps and pedicled flaps in head and neck reconstruction

Richard E. Hayden, Thomas H. Nagel

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Purpose of Review: This article reviews literature pertaining to the evolution in head and neck reconstruction techniques over the past two decades, specifically the changing patterns of usage of locoregional flaps and microvascular free tissue transfer. Recent Findings: Most literature demonstrates a continuing trend favoring microvascular free tissue transfer for the majority of large defects. A few pedicled flaps, some new and some resurrected, now provide expanded and sometimes superior options for certain head and neck defects. Considerations driving flap choice include defect composition, oncologic, aesthetic, and functional factors. Summary: Although osteocutaneous microvascular free flaps remain the standard of care for composite oromandibular defects, there may be a groundswell in the use of certain locoregional pedicled flaps for reconstructing many facial, intraoral and pharyngeal soft tissue defects. Evolution in the use of these locoregional flaps may help improve upon the standard of care for reconstructive options.

Original languageEnglish (US)
Pages (from-to)305-310
Number of pages6
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Issue number4
StatePublished - Aug 2013


  • free flaps
  • head and neck
  • pedicled flaps

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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