Objective: The descriptive clinical study was conducted to assess the cervico-facial tissue necrosis post-radiation therapy and the surgical management outcome with complete resection of the lesion plus vascular pedicle flaps reconstruction. Subject and method: 15 patients suffered from tissue necrosis post-radiation therapy were treated by 11 osteo-cutaneous fibular free flaps and 5 ALT free flaps (there was 1 patient using 2 flaps). Result: There were 8 patients with necrotic soft tissue in combination with bone defects, 3 patients with through-and-through cheek defects. These types of lesions practically required much larger defected tissue resections than the pre-operative assessment based upon clinical and imaging studies. The total flap survival were observed in 14 patients among total of 16 patients. Among 11 patients with long-term follow up, there were 9 patients with good results. Conclusion: Tissue necrosis in the cervico-facial area post radiation therapy need to be surgically removed and the size of the resected lesions were often larger than that of the clinically observed lesions: on imaging studies. Complete resection of the lesion combined with reconstructive surgery by vascular pedicle flaps resulted in good functional and cosmetic results.
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