Use of the keystone island flap for advanced head and neck cancer in the elderly - a principle of amelioration

Traditional management strategies of advanced head and neck cancer in the elderly include palliation and radical resection with microsurgical reconstruction. The keystone flap approach is an alternate reconstructive technique with a range of benefits for the aging population. This publication presents a series of elderly patients with head and neck cancer who underwent resection and reconstruction using the keystone flap principles. The aim is to demonstrate the value of this reconstructive technique in the various anatomical regions of the head and neck. Various operative sequences are accompanied by illustrations and discussions of the underlying principles. Crown Copyright (C) 2009 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.