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Modern trends in post malignancy reconstruction target more aesthetic and functional outcome with more patient satisfaction.This study aims to weight the oncological, technical, aesthetic and functional considerations and propose a novel scoring system in selection of an ideal local and locoregional flap for oncoplastic head and neck reconstruction. Patients and Methods: 52 local and locoregional flaps were created in 52 patients those were squeduled for head and neck tumour resection and defects reconstruction. These cases have been classified into six groups according to the flaps used in reconstruction. Oncological, technical, aesthetic and functional considerations were reviewed in each case. The data were collected as a prospective study throughout a 2-year period. Results: By analysis of the pre-requisites, operative findings and outcomes of reconstructions, multipleparameters; oncological, technical, aesthetic and functional were evaluated. All significant positive considerations were grouped and compared in each flap type. According to the weight of these considerations, a proposal of a scoring system (OTAF score) was formulated. Conclusion: This study provides a simplified systematic method of flap selection for post malignancy head and neck reconstruction through a scoring system (OTAF score) using oncological, technical, aesthetic and functional considerations. Individualized selection for each case still has its place however further evaluation and modifications of this scoring system is essential to maximize the results of our reconstructive tools.

OTAF Score: A Novel Scoring System for Selection of an Ideal Local and Locoregional Flap for Oncoplastic Head and Neck Reconstruction