Combined Anteroposterior Tibial Perforator-based Flap with a Vascularized Deep Peroneal Nerve for Repair of Facial Defect

Free Vascularized Lateral Femoral Cutaneous Nerve Graft with Anterolateral Thigh Flap for Reconstruction of Facial Nerve Defects

“…1 However, the recipient beds of the nerve graft are often accompanied by poor vascularization as a result of scarring from previous surgery, preoperative irradiation, and facial skin defects over the nerve graft after tumor resection. 2,3 Moreover, the use of a long nerve graft (more than 6 cm) and a patient age greater than 60 years could also be risk factors against nerve regeneration. 2 In recent years, the effectiveness of vascularized nerve grafts has been reported for cases that have these risk factors.…”

“…2 In recent years, the effectiveness of vascularized nerve grafts has been reported for cases that have these risk factors. [2][3][4][5][6][7] We have used a free vascularized lateral femoral cutaneous nerve graft with an anterolateral thigh flap for the repair of facial nerve defects after resection of a malignant parotid tumor.…”

Facial Nerve Reconstruction Using a Vascularized Lateral Femoral Cutaneous Nerve Graft Based on the Superficial Circumflex Iliac Artery System: An Application of the Inferolateral Extension of the Groin Flap

“…[1][2][3][4][5][6][7][8][9][10][11][14][15][16][17][18][19] In head and neck surgery, vascularized nerve grafts with or without skin flaps have been used for immediate reconstruction of the facial nerve. These include use of great auricular nerve grafts based on the posterior auricular vessels; 14 brachial cutaneous nerve grafts based on the radial artery; 15 sural nerve grafts based on the superficial sural artery, branches of the peroneal artery, or the gastrocnemius perforators; 16,17 deep peroneal nerve grafts based on the anteroposterior tibial perforators; 18,19 LFCN and/or motor nerve grafts from the vastus lateralis muscle based on the perforators from the descending branch of the circumflex femoral artery; 10,11 or fascicular turnover flap from the facial nerve. 20 Kimata et al and Iida et al reported satisfactory results following the use of a vascularized LFCN graft attached to an anterolateral thigh flap, suggesting that the LFCN is suitable for vascularized nerve grafts.…”

Use of Flap Based on Anterior Tibial Artery for Free Transfer

“…The flap also has hair growth, and it should not be used in female patients because the donor scar is in an exposed area. 7 Although a lateral sural artery perforator flap or a peroneal artery perforator flap can capture the same skin territory, the status of the peroneal artery cannot be evaluated clinically by palpation, unlike the anterior and posterior tibial vessels. Also, access to the peroneal ALTERNATIVE RECIPIENT SITE FOR THIGH FREE FLAPS/XU ET AL vessels is technically difficult in the presence of an intact fibular bone.…”