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The new innovation of the lower medial thigh perforator flap for head and neck reconstruction
Author(s) -
Scaglioni Mario F.,
Kuo PaoJen,
Chen YenChou,
Lin PaoYuan,
Kuo YurRen
Publication year - 2016
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22497
Subject(s) - medicine , surgery , medial compartment of thigh , inguinal ligament , free flap , superior thyroid artery , facial artery , perforator flaps , dissection (medical) , thigh , venous thrombosis , superficial temporal artery , anatomy , thrombosis , thyroid , ischemia , cardiology , middle cerebral artery
Background The choice of optimal flap is still a challenge for patients with resection of head and neck cancer and reconstruction, especially for recurrent cases. In this article, we report the results of the new innovation of free lower medial thigh perforator (LMTP) flap for head and neck reconstruction in a series of patients. Patients and Methods Fifteen patients received reconstruction with free LMTP flaps. The defect locations included the buccal area (3 cases), tongue (6 cases), lower/upper gum (5 cases), and soft palate (1 case). The perforators of flap design were detected at the distal third of the line, which was drawn from the midpoint of inguinal ligament to medial upper border of patella. The superficial temporal artery (7 cases), superior thyroid artery (6 cases), and facial artery (2 cases) were dissected as recipient vessels. Results The flap sizes varied from 12 × 5 cm 2 to 20 × 8 cm 2 . One to two perforators based on the superficial femoral artery or descending genicular artery were found between the septum of satorius and vastus medialis, or piercing the vastus medialis during dissection. All of flaps were survived after surgery, except one failed due to venous thrombosis. Another one flap suffered from venous thrombosis and was successfully salvaged by performing a venous thrombectomy. All donor sites were primarily closed except one skin grafting. The follow‐up time ranged from 3 to 15 months (average: 7 months) and all patients had good recovery with satisfactory results. Conclusion The LMTP flap indicates a pliable with constant vascular anatomy and low donor‐site morbidity. It could be an alternative for reconstructing defects in head and neck region. © 2015 Wiley Periodicals, Inc. Microsurgery 36:284–290, 2016.