Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
Department of Oral and Maxillofacial Surgery, Southwest Medical University Affiliated Stomatological Hospital, Luzhou Sichuan, 646000,
Published: June 2017
Objective: To investigate the efficacy of anterolateral thigh (myocutaneous) flap designed with computed tomography angiography (CTA) to reconstruct oral and maxillofacial soft tissue defects.
Methods: Between January 2011 and December 2015, 23 cases of oral and maxillofacial tumors were treated. There were 14 males and 9 females with the age range from 45 to 72 years (mean, 56.8 years). There were 12 cases of tongue carcinoma, 5 cases of buccal mucosa carcinoma, 4 cases of mouth floor carcinoma, and 2 cases of oropharynx carcinoma; all were squamous cell carcinoma. According to standard TNM staging of the Union for International Cancer Control (UICC), 8 cases were rated as T N M , 3 cases as T N M , 1 case as T N M , 4 cases as T N M , 2 cases as T N M , 2 cases as T N M , 2 cases as T N M , and 1 case as T N M . The course of disease was 1-6 months (mean, 2.4 months). CTA was performed before operation to locate the perforator vessel and its surface projection of emerging point and to design anterolateral thigh (myocutaneous) flap by computer. The defects of soft tissue ranged from 6 cm×4 cm to 11 cm×7 cm after resection of tumor. The flap was used to repair defects, including 14 thinned anterolateral thigh flaps, 7 anterolateral thigh myocutaneous flaps, and 2 anterolateral bilobed flaps; and the flap area ranged from 7 cm× 5 cm to 12 cm×8 cm. The donor sites were sutured directly.
Results: CTA showed that myocutaneous perforators penetrated at the fascias of the vastus lateralis muscles in 22 cases with a location rate of 95.7% (22/23). Submandibular fistula occurred in 1 case at 5 days after operation and fistula healed after changed dressings. Other wounds at recipient site and donor site healed at primary stage. Anastomose with 2 vein was performed because of poor venous return in 1 case, and the flap survived. The other flaps survived well. All the patients were followed up 6-36 months (mean, 16.4 months). At 3 months after operation, the simplified recovery standard of speech function and swallow function was established according to the University of Washington Quality of Life Scale (UW-QOL). The speech and swallow function recovered satisfactorily in 22 cases, and not very satisfactorily in 1 case of well differentiated squamous cell carcinoma of the right mouth floor (T N M ). No obvious tissue atrophy was observed in 23 cases. No dysfunction was found at the donor site. There was no tumor recurrence in 21 patients; 1 patient accepted the second operation due to lymphonodi metastasis of contralateral neck at 6 months after first operation, who died after 23 months; 1 patient died of distant metastasis at 10 months after first operation.
Conclusion: The anterolateral thigh (myocutaneous) flap designed with CTA could well recover the morphology and function of the recipient site.
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http://dx.doi.org/10.7507/1002-1892.201612132 | DOI Listing |
Cureus
December 2024
Infectious Disease, Tan Tock Seng Hospital, Singapore, SGP.
Nontyphoidal is a common cause of gastroenteritis but can also lead to bacteremia and extraintestinal infections, including meningitis (more frequent in children and infants), endovascular infections (e.g., endocarditis and infected aneurysms), urinary tract infections, and bone or bone marrow infections (e.
View Article and Find Full Text PDFJ Stomatol Oral Maxillofac Surg
January 2025
Department of Oral Maxillofacial Surgery; The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address:
Background: The thin anterolateral thigh flap (tALTF) is gaining attention in reconstructive surgery due to its aesthetic and functional advantages. However, its clinical safety and outcomes compared to other commonly used free soft flaps (CUFSFs) remain unclear.
Methods: Studies were systematically searched from PubMed, EMBASE, Medline, Cochrane, Web of Science, and China National Knowledge Infrastructure Database up to November 2, 2024.
JPRAS Open
March 2025
Department of Plastic & Reconstructive Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Balearic Islands, Spain.
Introduction: Extensive scalp defects present a significant reconstructive challenge due to the complex needs of patients that are often beyond the scope of conventional therapies, which makes free flaps the most reliable solution. Despite the variety of free flaps available for such cases, there is a lack of clear criteria for selecting the most suitable option. The primary objective of this study was to provide a simplified guide for the selection of donor sites for free flaps for achieving optimal reconstruction outcomes.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2025
Section of Facial Plastic and Microvascular Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
Objective: Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).
Study Design: Retrospective chart review.
Setting: Single institution.
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately.
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