Secondary Revision Surgery Using a Tensor Fascia Lata Sling Following Head and Neck Reconstruction.

BACKGROUND

Osteocutaneous flaps are the standard approach for performing reconstruction after a mandibulectomy. Soft tissue reconstruction alone may be performed for tumor progression or patient burden; however, it may cause a loss of oral function and issues concerning cosmetic appearance. We performed secondary revision surgery using the tensor fascia lata. This report presents a contour revision surgery for one case in which optimal flap selection was not possible during immediate reconstruction due to various reasons.

METHODS

A 63-year-old woman with idiopathic thrombocytopenic purpura and left lower gingival cancer (pT4a N3, M0, Stage IVa) underwent left hemimandibulectomy and left neck dissection. Reconstruction was performed with a deep inferior epigastric perforator flap. Two years after the surgery, we performed a flap volume reduction and created a tensor fascia lata sling to correct a significant irregularity of the mandibular contour. The mandibular contour was greatly improved after revision surgery, and controlled occlusion was possible. A quality-of-life assessment indicated an improved cosmetic appearance.

CONCLUSION

This method is relatively simple and less invasive than bone grafting. It potentially solves some problems associated with mandibular reconstruction using only soft tissue.