Clinical application of free thin anterolateral thigh flap in the reconstruction of intraoral defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the clinical features and therapeutic effect of free thin anterolateral thigh flap for the reconstruction of intraoral defects.</p><p><b>METHODS</b>The clinicopathologic data of 34 cases with oral carcinoma were obtained from Institute and Hospital of Stomatology, Nanjing University Medical School, from December 2008 to December 2011. These 34 patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free thin anterolateral thigh flaps. The defects were located at tongue, buccal, mouth floor, and so on. The subcutaneous fat thickness of the flap at the site of the perforator is usually measured by ultrasound before the operation. If the thickness of the subcutaneous fat at the site of the perforator exceeded 1.5 cm, the patient was excluded from the study.</p><p><b>RESULTS</b>There were 16 male and 18 female patients. The mean age was 55.4 years. Among the 34 patients, 26 flaps with musculocutaneous perforators and 8 flaps with septo-cutaneous perforators were used. Partial flap necrosis occurred in 2 patients.</p><p><b>CONCLUSIONS</b>The free thin anterolateral thigh flap is the ideal soft tissue flap for the intraoral defects reconstruction. Satisfactory functional results can he achieved at recipient area with minimal morbidity at the donor site area.</p>

Reconstruction of oral soft tissue defects with free anterolateral thigh flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the clinical features and therapeutic efficacy of anterolateral thigh (ALT) flaps for the intraoral defects reconstruction.</p><p><b>METHODS</b>The clinicopathologic data of 67 cases with oral tumors were obtained from School of Stomatology, Nanjing University Medical Center from Dec. 2008 to Dec. 2010. All the patients underwent the simultaneous tumor resection and intraoral defects reconstruction with free anterolateral thigh flaps. The defects included the tongue, buccal, gingival, mouth floor, and so on. The descending branch of lateral femoral circumflex artery was anastomosed to the external maxillary artery or superior thyroid artery; the vein was anastomosed to the common facial vein or external jugular vein. The flaps were divided into three types: musculocutaneous ALT flap, fasciocutaneous ALT flap and thinned ALT flap.</p><p><b>RESULTS</b>There were 38 male patients and 29 female. The anterolateral thigh flaps included 35 musculocutaneous flaps, 17 fasciocutaneous flaps and 15 thinned flaps. The success rate was 98.5% (66/67). Partial necrosis happened in one case with diabetes, which healed after debridement and dressing. 1 flap was totally necrosis. Double venous anastomosis was performed in 41 flaps, and one venous anastomosis was performed in 26 flaps. 8 patients required operative exploration in the perioperative period including 6 flaps with thrombotic events (5 flaps were complete survival after the salvages, and 1 flap was failure) , 1 flap with hematoma, and 1 flap with twisting of perforator. The follow-up period ranged from 2 to 24 months( mean, 8.7 months). The result was satisfied. The donor sites were closed directly in all patients, and the wounds healed uneventfully.</p><p><b>CONCLUSIONS</b>The free anterolateral thigh flap is an ideal soft tissue flap for the intraoral defects reconstruction with good functional result at recipient area and less morbidity at the donor site.</p>

Application of titanium mesh and free forearm flap for reconstruction of maxillary defect resulted from tumor resection / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of titanium mesh and free forearm flap for reconstruction of maxillary defect resulted from tumor resection.</p><p><b>METHODS</b>From 2004 to 2008, 19 cases with maxillary tumor underwent tumor resection. The defects were reconstructed immediately with titanium mesh for bony defects and free forearm flap for oral mucosa defects.</p><p><b>RESULTS</b>16 cases achieved satisfactory functional and cosmetic results. The speech assessment was good without oronasal reflux. The titanium mesh was exposed and infected in 3 cases. Then the meshes were taken out and the defects were covered with the forearm flap to close the oronasal fistula. The midface was slightly depressed with no functional morbidity.</p><p><b>CONCLUSIONS</b>It is simple and practical to reconstruct maxillary defect with titanium mesh and free forearm flap. Both the functional and cosmetic results are satisfactory.</p>

The orthognathic treatment of mandibular asymmetry / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the methods of orthognathic treatment for mandibular asymmetry.</p><p><b>METHODS</b>110 cases of mandibular asymmetry had been treated in past thirteen years. The type of deformity, the management of the cases, and the effects of orthognathic treatment were summarized in this paper. Orthodontic therapy was taken before and after operation to keep the treatment effect.</p><p><b>RESULTS</b>According to the type of the asymmetry deformity, different methods were used. After treatment, all the patients obtained satisfactory facial appearances and oral function.</p><p><b>CONCLUSION</b>It should be diagnosed before surgery whether the development of deformity is steady or not. If it is steady, the effects of orthognathic and orthodontic therapy will be satisfactory; if not, we should remove the affected condyles and simulataneously ameliorate facial appearance.</p>