Application of 1,212 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects.</p><p><b>METHODS</b>Patients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1,185 patients, 1,212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed.</p><p><b>RESULTS</b>Among the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=-0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05).</p><p><b>CONCLUSION</b>Anterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.</p>

Autogenous Cranial Bone Grafts for Treating Oral and Maxillofacial Deformity / 中国医师杂志

Objective To evaluate the effect of the autogenous split-thickness cranial bone grafts on treatment of deformity of oral and maxillofacial regions. Methods The split-thickness cranial bone was harvested through the coronal incisions or the parietotemporal region incisions. The bone graft was then fashioned to the appropriate size and configuration and fixed to the regions of defects and deformities. The cranial bone was used to reconstruct facial bone framework or as sustaining bone graft for facial augmentation. Results 31 patients with the oral and maxillofacial deformities or bone defects were repaired with the cranial bone grafts, including 17 cases of orbital floor defects, 6 cases of malunion of the zygoma fractures, 5 cases of secondary deformity after ankylosis of temporomandibular joint, 2 cases of bone reconstruction after tumor resection and 1 case of cleft palate deformity. The followed-up period ranged from 6 months to 7 years, averaging 11 months. There were no complications of infection and extrusion, no obvious bone resorption was observed, and the facial appearance were greatly improved. Only one patient had a small ectropion which persisted three months. After six-month, the ectropion was not obvious. Conclusion Autogenous bone grafts used to reconstruct the defect and deformity of oral and maxillofacial regions can reduce the risks of infection and extrusion, and there is less visible scar and less bone resorption. Skull bone is an ideal source of bone graft material in the oral and maxillofacial deformity.