Reconstruction Using a Bilobed Flap in a Patient With Recurrent Neck Soft Tissue Metastasis From Oral Cancer: A Case Report

Soft tissue defects in the head and neck are frequently encountered, often resulting from trauma or the surgical management of malignancies. Flap reconstruction plays a critical role in the closure of these defects, aiming to minimize complications and improve cosmetic outcomes. While various flap techniques are commonly utilized in head and neck reconstruction, to the best of our knowledge, the bilobed flap has not been previously reported in this anatomical region. We present a case involving a patient with a complex underlying medical condition, which elevated the risks associated with prolonged anesthesia. In light of these considerations, we opted to use a bilobed flap, which was successfully employed for the reconstruction of an intermediate-sized soft tissue defect in the right submental area following resection of recurrent oral cancer. After undergoing multiple surgeries and concurrent chemoradiotherapy, the 65-year-old male patient developed significant neck stiffness, making direct closure unfeasible and traditional local flap techniques ineffective for wound management. The bilobed flap was meticulously planned, with the first lobe positioned over the adjacent site of the right submental defect and the second lobe located next to the first lobe, employing a double transposition design. The flap healed without complications, and the patient experienced a good recovery. This case report underscores the effectiveness of bilobed flaps in reconstructing moderate-sized soft tissue defects in patients with recurrent neck metastatic oral cancer after previous neck dissection and concurrent chemoradiotherapy.