[Clinical application of thoracodorsal artery perforator flaps in the repair of head and neck defects].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi

Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai 200011, China.

Published: September 2021

AI Article Synopsis

  • The study analyzed the use of thoracodorsal artery perforator flaps (TDAPF) for repairing head and neck defects in 38 patients who had surgery for oral and maxillofacial tumors.
  • All flaps successfully survived, and TDAPF showed significantly lower skin elasticity and hardness compared to other types of flaps like the anterolateral thigh and forearm.
  • The patients had good functional recovery post-surgery, with minimal scarring and no major complications, indicating TDAPF is an effective option for head and neck reconstruction.

Article Abstract

To analyse the clinical application of thoracodorsal artery perforator flaps (TDAPF) in the repair of head and neck defects. A retrospective review was conducted on 38 patients with oral and maxillofacial head and neck malignant tumors who underwent radical resection of oral and oropharyngeal carcinoma and TDAPF repair in the Department of Oral and Maxillofacial Head and Neck Oncology of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2017 to November 2018. Among them, 32 were males and 6 were females, aged 30-74 years. Flap size, vessel pedicle length, diameter and number of perforators, and flap fat thickness were recorded and counted. Elasti Meter and Skin Fibro Meter were applied to measure the skin elasticity and hardness in the donor areas of 4 kinds of skin flaps before the flap preparation. SPSS 19.0 statistical software was used for statistical analysis of the data. All the flaps survived (100%). The mean elasticity of TDAPF [(41.2±12.9) N/m] was significantly lower than that of anterolateral thigh [(77.6±23.3) N/m, χ²=88.89, <0.05], anterolateral thigh [(62.6±17.7) N/m, χ²=59.99, <0.05] and or forearm flap [(51.7±8.6) N/m, χ²=37.82, <0.05]. The hardness of TDAPF [(0.037±0.016) N] was also significantly lower than that of anterolateral femoral [(0.088±0.019) N, =93.27, <0.05], anteromedial femoral [(0.059±0.020) N, =25.71, <0.05] or forearm flap [(0.062±0.016) N, =29.11, <0.05]. Follow-up period ranged from 2 to 14 months. The 38 patients treated with TDAPF had a good recovery of the functions in the recipient areas, and the scars of the donor areas were not obvious after surgery, without serious complications. TDAPF is suitable for reconstruction of head and neck defect, with ductile texture and good recovery of the morphology and function of head and neck.

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http://dx.doi.org/10.3760/cma.j.cn115330-20210429-00238DOI Listing

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