Compared with the posterior route, the anterior route may be considered as a shorter choice for the conduit to reach the cervical region for esophageal reconstruction.
The bipedicle island flap has two arterial systems to provide sufficient blood supply. This technique provides another option for thumb reconstruction when a large supercharged FDMA island flap needs to be designed, or when there is an additional injury to the radial side of the dorsum of the hand or if there are anatomical variations of the FDMA, or if damage to the FDMA occurs during surgery.
The mean value of the upper puncture angle was 30° (range 23.5-39°) while the lower puncture angle was also 30° (24-40°). Surgery procedures for implanting silastic sheets succeeded in 20 patients by extra-endolaryngeal puncture access. The average numbers of upper and lower punctures were 2 and 1.6, respectively. At follow-up none of the 20 patients had webs or had only 1 mm adhesion area.
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