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J Reconstr Microsurg 2015; 31(04): 319-326
DOI: 10.1055/s-0035-1544180
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Medial Sural Artery Perforator Flap for Postsurgical Reconstruction of Head and Neck Cancer

Xiaomeng Song
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
*   Both the authors contributed equally to this work.
,
Heming Wu
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
*   Both the authors contributed equally to this work.
,
Wei Zhang
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
,
Jie Chen
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
,
Xu Ding
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
,
Jinhai Ye
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
,
Yunong Wu
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
,
Ye Yuan
1   Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China
2   Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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23. September 2014

16. November 2014

Publikationsdatum:
09. Februar 2015 (online)

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Abstract

Background This article aims to describe the application of medial sural artery perforator flaps (MSAPs) in reconstruction of defects following ablation of head and neck cancer.

Methods The study included 24 patients (10 males and 14 females). A total of 24 MSAPs were harvested to reconstruct defects caused by the dissection of malignant tumors of the oral and maxillofacial regions. Overall, 20 radial forearm free flaps (RFFs) and 16 anterior lateral thigh perforator flaps (ALTPs) were included in the donor site cosmetic assessments. Visual analog scale (VAS) score was used to assess postoperative oral function and cosmetic results.

Results A total of 22 (92%) flaps healed without venous insufficiency. The external diameter of the medial sural artery for anastomosis was 2.2 mm (range, 1.3–2.5 mm), and the external diameter of the venae comitantes was 2.6 mm (range, 1.5–3.5 mm). Esthetic satisfaction with the primary site had a VAS score of 6.38 ± 1.89, while the donor site had a score of 7.34 ± 1.28. Use of MSAP and ALTP showed significantly higher esthetic satisfaction at the donor site than with RFF (p < 0.001 and p < 0.05, respectively).

Conclusion MSAPs show a strong advantage for donor site esthetic outcome and can be a good choice for the repair of defects of the maxillofacial area after cancer ablation.

Keywords

medial sural artery perforator flap - squamous cell carcinoma - head and neck