Preoperative Doppler evaluation of vascular perforators in the anterolateral thigh flap harvest / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the accuracy of Hadeco ES-1000spm hand-held doppler during the anterolateral thigh (ALT) flap harvest.</p><p><b>METHODS</b>Twenty-five patients (26 sides) with ALT flaps for head and neck reconstruction between May 2005 and May 2010 received preoperative Doppler examination for the location of the cutaneous perforators of ALT flaps. The Doppler signals and body mass index (BMI) were recorded preoperatively according to ABC system. The locations of Doppler signals and of the actual cutaneous perforators at surgery were plotted and compared. The diameter of perforators was measured.</p><p><b>RESULTS</b>One to three cutaneous perforators of the ALT flap were consistently found at specific locations. They were named perforators A, B, C from proximal to distal. Perforators A, B and C were present in 15 (58%), 24 (92%) and 20 (77%) cases and the diameter (> 0.5 mm) of A, B and C were 11/15, 22 (92%) and 8 (40%) respectively. The Doppler signal was within 0.5 cm of the actual perforator location in 85% flaps. The accuracy of Doppler decreased with increase of BMI.</p><p><b>CONCLUSIONS</b>Preoperative assessment by hand-held Doppler is useful in predicting the perforator vessels' locations and diameter although it's accuracy is limited.</p>

Functional reconstruction of total lower lip defect with mental neurovascular V-Y advancement island flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To introduce a method of functional reconstruction for total lower lip defects.</p><p><b>METHODS</b>Six patients with lower lip cancer were treated by surgery from November 2007 to February 2009. The full thickness defects with a size from eighty percent to total lower lip were reconstructed with two triangular mental neurovascular island flaps of chin. The musculocutaneous and mucous flaps with neurovascular pedicles were advanced in a V-Y manner to close the defect and reconstruct the orbicularis oris muscle.</p><p><b>RESULTS</b>All flaps survived and no recurrence and complication were observed and showed excellent cosmetic and functional results over 6 months of follow-up. The reconstructed lower lips provided a wide-enough mouth opening, and the sensation of oral mucosa and the muscle function of oral sphincter were preserved.</p><p><b>CONCLUSIONS</b>The technique of mental neurovascular V-Y advancement island flap can get satisfactory results in both functional and the aesthetic perspects.</p>