Data Collection and statistical analysis:
The following data elements were collected for each patient in the cohort: basic demographics, social history, defect classification, previous treatment, ablative procedure, donor site morbidity, salivary bypass tube use, and functional outcomes. Skin paddle dimensions, recipient blood vessels, and venous coupler sizing were collected. Surgical outcomes and complications were documented from flap donor site and reconstructive site. SLP data including voice outcomes, swallowing outcomes, enteral feeding usage, and tracheoesophageal puncture (TEP) usage were reviewed and descriptive statistics performed.