الفهرس 
Introduction
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Abstract
Defects following head and neck surgery can be closed by direct closure when the defect is small, and where local conditions dictate that there is enough lax tissue. However, for larger defects or in situations when direct suture is not applicable, surgical defects may be filled by free grafts, local flaps, pedicled flaps which may be either axial or musculocutaneous , or by using free tissue transfer.
Most surgeons can perform head and neck ablative surgery. The test of skill comes in performing head and neck reconstructive surgery and the size of a defect should never be underestimated. The care and skill that go into the planning of the reconstruction will usually pay off in terms of long-term functional outcome.
This study was conducted in attempt to clarify the following:-
• The success rate of different types of flaps in common use for head and neck reconstruction.
• The effectiveness of different flaps in terms of functional and esthetic results.
• Which flap is the best for certain defects in head and neck region.
This study was conducted upon 38 patients, they were 9 (23.68 %) females and 29 (76.31 %) males with a mean of age of 61 years (range 36- 84 years).
According to the site of the defect needed to be reconstructed after ablation of the primary lesion, patients were divided into three groups:
1. Patients with defects in the oral cavity and oropharynx which resulted from resection of malignant tumors involving or extending into oral cavity and oropharynx (26 patients) “G1”.
2. Patients with defects in the hypopharynx which resulted from resection of cancer involving the hypopharynx (8 patients) “G2”.
3. Patients with post maxillectomy defects following resection of sinonasal cancer (4 patients) “G3”.
In this study all defects resulted from resection of primary lesions were reconstructed immediately after ablation. As regarding patients with oral and oropharyngeal defects (n=26), the most common flap that was used in reconstruction was the pectoralis major myocutaneous flap, that was used in ten patients followed by the radial forearm fasciocutaneous free flap that was used in seven patients, transverse rectus abdominas myocutaneous(TRAM) flap that was used in four patients, the fibula osseocutaneous free flap that was used in three patients and lastly the scapula free flap which was used in two patients.
For hypopharyngeal defects (n=8), reconstruction was done in all patients with the free jejunal flap except in a single patient that was performed with the pectoralis major myocutaneous flap.
In patients with craniosinonasal defects (n=4), the TRAM flap was used in four patients to seal the oro-nasal communication and the fascia lata for reconstruction of the anterior skull base defects.
Overall evaluation of different types of flaps for reconstruction of head and neck defects revealed that radial forearm free flap and PMMF is the best two choices in terms of flap survival and functional outcome for reconstruction of oral cavity defects, free jejunal flap gave fair results for reconstruction of the hypopharynx and finally the TRAM flap isn’t the best choice for reconstruction of the maxillary defects.