Clinical application of free anterolateral thigh flap in the reconstruction of oromaxillo-facial defects / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the possibility and practicality of using free anterolateral thigh flap to repair defects of oromaxillo-facial region.</p><p><b>METHODS</b>One hundred and seventy-two patients underwent anterolateral thigh flap (ALP) reconstruction from Jan. 2007 to Dec. 2008. The size of the defect ranges from 4 cm x 4 cm to 10 cm x 25 cm. One hundred and six flaps were used for tongue reconstruction, 14 flaps for buccal reconstruction, 15 flaps for mouth floor reconstruction, 1 flap for lower lip and mental region reconstruction, 6 flaps for hard and soft palate reconstruction, 3 flap for maxillary part reconstruction, 18 flaps for submaxilla part reconstruction, 2 flaps for pharynx oralis reconstruction, 3 flaps for repairing large-area defect of facial, 1 flap for repairing neck and shoulder region and 3 flaps for repairing defect of Infratemporal fossa. Of these flaps, 151 were musculocutaneous flaps, 13 were fasciocutaneous flaps and 8 were chimeric flaps.</p><p><b>RESULTS</b>The success rate reaches 98.3% (169 of 172). Postoperatively, 4 cases encountered vascular crisis, 1 of which survived completely with successful vessel exploration, 3 cases with partial necrosis; and 3 cases with complete necrosis. One case with bleeding after operation. Six cases with parotid fluidly and parotid fistula, 8 cases with mouth floor fistula, 6 cases with infection, 3 cases with infection and partial necrosis on the lateral thigh. All patients achieved acceptable contour, appearance and function.</p><p><b>CONCLUSION</b>Free anterolateral thigh flap can repair kinds of complicated defects on oromaxillo-facial region.</p>

The chimeric perforator flap pedicled with descending branch of lateral circumflex femoral artery for reconstruction of oromaxillary soft tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To report the application of the chimeric perforator flap pedicled with descending branch of lateral circumflex femoral artery for large and complicated oromaxillary soft tissue defect.</p><p><b>METHODS</b>Based on the anatomic study of descending branches and cutaneous perforators of lateral circumflex femoral artery, the perforator vessels were found and used as flap pedicle. The perforator flap was made as chimeric flap for repairing the oromaxillary soft tissue defect in 8 cases. The chimeric perforator flaps were divided into three types as anterolateral thigh flaps and anteromedial thigh flaps, anterolateral thigh flaps and rectus femoris perforator flaps, and anterolateral thigh flaps and anterolateral thigh flaps.</p><p><b>RESULTS</b>All the 16 flaps in 8 cases survived completely with no complication. The wounds in donor sites were all primarily closed with no skin graft. The patients were followed up for 1-9 months with good functional and esthetic results. There was no morbidity in donor sites.</p><p><b>CONCLUSIONS</b>The chimeric perforator flap has a large tissue volume for large and complicated oromaxillary defect. There is no need for extra donor site and extra blood vessel anastomosis.</p>