The repair of defects in the head and neck region with the latissimus dorsi myocutaneous flap.

There are many different flaps available for head and neck reconstruction. The latissimus dorsi myocutaneous flap has been widely used in this unit on 80 occasions in the past three years, both as a pedicled and as a free microvascular flap following the excision of head and neck malignancy, the commonest pathology being intraoral squamous cell carcinoma. There were nine cases of complete or substantial flap loss requiring a further reconstructive procedure. Few of the patients who underwent total glossectomy suffered from overspill or aspiration and the fistula rate was low. Reference is made to the anatomy and the technique of raising this versatile flap which provides a large volume of tissue and has been particularly useful following total glossectomy when combined with a hyoid hitch.