Modified design and clinical application of head and neck island muscle flap and flap / 中国耳鼻咽喉头颈外科

ABSTRACT

[ABSTRACT]OBJECTIVETo investigate the safety of the head and neck muscle pedicle flap or flaps with single vascular pedicle.METHODSThe characteristics of thoracoacromial artery were investigated in 20 autopsy cases. Farthest point into the muscle were checked by preoperative ultrasonography and intraoperative localization with perspective observation, the muscles 1-2 cm above the farthest point were cut off from the donor site, forming a simple arteriovenous island flap pedicled pectoralis major muscle. Using the same technology and methods, sternocleidomastoid island and lower trapezius island flap were harvested.RESULTSAnatomical observation revealed thoracoacromial artery single type accounts for 12.5% (5/40), double vessel type 67.5% (27/40), multiple vessel type 20% (8/40). The rate of furthest point localization with preoperative ultrasound was 29.1% (14/48), the DSA successfully developed breast artery perforator in 66.7% (12/18) of the cases. Forty eight pectoralis major island muscle flaps, 12 internal mammary artery flaps, 18 chin flaps, 4 lower trapezius island myocutaneous flaps, 4 sternocleidomastoid island myocutaneous flaps, 3 transverse cervical artery island shaped flaps, 3 thoracoacromial artery perforator island flaps were harvested. Two flaps were failure. Partial necrosis occurred in 3 pectoralis major myocutaneous flaps.CONCLUSIONThe design of single vascular pedicle island flap for the head and neck defects is feasible and safe, and patients benefite not only for easily shaped the island flap, but also for the region appearance and function preservation in both the donor site and recipient site.