ABSTRACT
Objective:To assess the anatomy of superficial circumflex iliac artery perforator (SCIP) and its feasibility for tongue re-construction after tumor resection. Methods:From January 2014 to January 2015, a total of 15 patients with oral maxillofacial defects underwent SCIP flap surgery. Perforator identification and SCIA course were performed intra-operatively. The relationships among the SCIA, deep circumflex iliac artery (DCIA), and superficial inferior epigastric artery (SIEA) were determined intra-operatively. Surgical procedures, measurement of vessel's caliber and pedicle's length, SCIP flap anatomy, and their outcomes were described. Results:Flap mean thickness was approximately 1.2±0.3 cm. The mean diameter of the SCIA was 0.7±0.2 cm, and that of the superficial circumflex iliac vein was 1.2±0.2 cm. The relationships among SCIA, DCIA, and SIEA were described and subdivided into typeⅠ(8/15), typeⅡ(2/15), typeⅢ(2/15), typeⅣ(2/15), and typeⅤ(1/15) in intra-operative dissection. The flap sizes were in the range from 6 cm × 4.5 cm to 11 cm × 10 cm. A total of 14 SCIP flaps survived, and 1 SCIP flap underwent necrosis. Conclusion:The SCIP flap is a reliable, thin, and pliable flap with long vascular pedicles and hidden donor site morbidity. Its texture is a perfect match for tongue defect reconstruc-tion.
ABSTRACT
Objective:To evaluate the accuracy of the application of color Doppler sonography (CDS) and computer tomography angiography (CTA) in preoperative perforator identification and flap design and provide theoretical support for the restoration of oral maxillofacial defect with free superficial circumflex iliac artery perforator flap (SCIAPF). Methods: (1) Preoperative CDS and CTA techniques were performed to map the SCIA perforators of 29 adult patients diagnosed with malignant tumor in the oral maxillofacial head and neck regions. These patients were scheduled for concurrent reconstruction surgery. (2) A diagnostic test was designed to com-pare the CDS and CTA techniques. Results:(1) A total of 18 patients underwent flap preparation. SCIA was not found in one of the pa-tients during surgery, but was observed intra-operatively in the other 17 patients. The average SCIA diameter was 0.69 ± 0.20 mm. (2) The diagnostic test showed a CDS sensitivity of 75.0%, a CDS specificity of 82.4%, and an area under the ROC curve of 0.79. The CTA sensitivity was 75.0%, the specificity was 94.2%, and the area under the ROC curve was 0.85. The diameters measured by CDS and CTA were compared with the diameter measured intra-operatively. Significant differences were observed among the three diame-ters (P<0.05). The average diameter measured by CDS was 0.84 ± 0.14 mm. The average diameter measured by CTA was 1.01 ± 0.19 mm. Conclusion:CDS and CTA are relatively reliable technologies for preoperative detection of perforator vessel. The use of CDS and CTA technology mapping for SCIAPF can provide accurate information about the perforator, including the position of the perforator and the relationship between the peripheral tissues and the caliber of the vessel.