Regional flaps: a move to simpler reconstructive options in the head and neck

The use of regional flaps in head and neck reconstruction is experiencing a resurgence. This review surveys the growing body of clinical evidence supporting these techniques. The supraclavicular flap and submental island flap are two regional flaps that provide thin pliable tissue for head and neck reconstruction. The submental island flap has been demonstrated to be oncologically safe in the setting of oral cavity malignancy in patients without clinical level I disease. For moderate mucosal defects, the facial artery myomucosal flap and palatal island flap provide regional options for reconstruction with minimal donor-site morbidity. The pectoralis major and latissimus dorsi flap remain excellent options in patients medically unsuitable for a free flap, salvage reconstructions, vessel depleted necks and when the defect is able to accommodate the bulk of the flap. Regional flaps continue to evolve and remain an integral part of a reconstructive surgeon's armamentarium. A working knowledge of these techniques is integral to maximizing outcomes for head and neck reconstructions, while minimizing morbidities and cost.