Computed tomography angiography imaging for the chimeric anterolateral thigh flap in reconstruction of full thickness buccal defect

Chiu, Wen Kuan; Lin, Wea‐Lung; Chen, Shih Yi; Tzeng, Wei Da; Liu, Shao‐Cheng; Lee, Tzu Peng; Chen, Shyi Gen

doi:10.1111/j.1445-2197.2010.05483.x

Cited by 40 publications

(35 citation statements)

References 18 publications

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“…In cases of only 1 septocutaneous perforator identified in distal thirds of the lateral leg, the skin paddle derived from a musculocutaneous perforator over the proximal region could be used for double-skin paddle creation if needed. 25 In consideration of the flap complication rate on multiple-skin paddle flap for reconstruction of composite and en bloc mandibular defects, Chiu et al 26 found the incidence of partial flap loss (11%), neck wound infection (22%), and saliva leakage (11%) in 9 patients by double-skin paddle ALT flap. Although using double-skin paddle OMC peroneal flap, Cheng et al 10 documented partial skin paddle failure (11.7%), facial abscess (5.9%), and wound dehiscence (5.9%) in 17 patients.…”

Section: Discussionmentioning

confidence: 99%

Oromandibular Reconstruction With Chimeric Double-Skin Paddle Flap Based on Peroneal Vessel Axis for Synchronous Opposite Double Oral Cancer

Huang

Liu

Chen

et al. 2015

Annals of Plastic Surgery

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Section: Discussionmentioning

confidence: 99%

Oromandibular Reconstruction With Chimeric Double-Skin Paddle Flap Based on Peroneal Vessel Axis for Synchronous Opposite Double Oral Cancer

Huang

Liu

Chen

et al. 2015

Annals of Plastic Surgery

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“…Nevertheless, in the case of a single ALT dominant perforator the combination fibula osseocutaneous flap and ALT‐vastus lateralis chimeric flap would be a safer option. Preoperative CT angiography could be very useful in establishing the operative plan (Chiu et al, ; Chen et al, ).…”

Section: Discussionmentioning

confidence: 99%

Single stage aesthetic and functional reconstruction of composite facial gunshot wound with a chimeric functioning muscle and fibular osseous flap. Case report and review of the literature

et al. 2017

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The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle. The one skin paddle of the chimeric flap reconstructed the buccomandibular/suborbital zones of the cheek, and the other the lining of the mouth. The functional muscle provided reanimation of the corner of the mouth by coapting the muscle's motor nerve to the ipsilateral marginal mandibular nerve. A good facial contour and reanimation of the mouth with oral continence was achieved, and the patient presented with good social and emotional smile. This first report of combined use of a fibula osseous flap with a chimeric functional ALT/Vastus Lateralis flap suggests that the chimeric flap principle may be used in complex aesthetic and functional challenges of severe facial trauma.

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“…Shaw et al [22] speculated that false positives represented either pure muscular perforators, or signals from the main descending branch because of their proximity to the tip of the probe when the intervening layer of fat is minimal. Chiu et al considered that preoperative multi-detector computed tomographic angiography (CTA) could be performed to map perforator and evaluate the dominant vascularity in the suitable thigh before transferring chimeric ALT flaps [23]. However, it was hard for CTA to show the direct location of cutaneous perforators just like Doppler for surgeons.…”

Section: Discussionmentioning

confidence: 99%

Multipaddled Anterolateral Thigh Chimeric Flap for Reconstruction of Complex Defects in Head and Neck

Jiang

Guo

et al. 2014

PLoS ONE

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The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14–23) cm and the mean width was 4.9 (range: 2.5–7) cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

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Computed tomography angiography imaging for the chimeric anterolateral thigh flap in reconstruction of full thickness buccal defect

Cited by 40 publications

References 18 publications

Oromandibular Reconstruction With Chimeric Double-Skin Paddle Flap Based on Peroneal Vessel Axis for Synchronous Opposite Double Oral Cancer

Oromandibular Reconstruction With Chimeric Double-Skin Paddle Flap Based on Peroneal Vessel Axis for Synchronous Opposite Double Oral Cancer

Single stage aesthetic and functional reconstruction of composite facial gunshot wound with a chimeric functioning muscle and fibular osseous flap. Case report and review of the literature

Multipaddled Anterolateral Thigh Chimeric Flap for Reconstruction of Complex Defects in Head and Neck

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