Free Anterolateral Thigh Fascia Lata Flap for Complex Nasal Lining Defects

Seth, Rahul; Revenaugh, Peter C.; Scharpf, Joseph; Shipchandler, Taha Z.; Fritz, Michael A.

doi:10.1001/2013.jamafacial.5

Cited by 50 publications

(55 citation statements)

References 14 publications

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“…The angular, facial, and superficial temporal vessels can be easily and reliably identified with minimal risk of damage to the facial nerve and excellent cosmesis, obviating the need for neck dissection for vessel exposure. 4 Despite the low morbidity and excellent cosmetic results of these approaches, the use of smaller caliber vessels for anastomosis may carry with it greater risk of flap failure. Minimal access approaches may also complicate attempts at revision or salvage when there is concern for early flap compromise.…”

Section: Discussionmentioning

confidence: 99%

Short‐stay hospital admission after free tissue transfer for head and neck reconstruction

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Short‐stay hospital admission after free tissue transfer for head and neck reconstruction

et al. 2016

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“…The primary search identified 305 unique articles, of which 257 were excluded after title and abstract review (Figure ). After 48 full‐text articles were reviewed by two independent reviewers (MR and GK), a total of 22 articles fulfilled the inclusion criteria (Acikel, Bayram, Eren, & Celikoz, ; Beahm, Walton, & Burget, ; Burget & Walton, ; Choi, Joo, Jeong, & Jang, ; Cinpolat, Bektas, & Coskunfirat, ; Fujioka, Hayashida, Murakami, & Koga, ; Gaggl, Burger, & Chiari, ; Hirase, Kojima, Takeishi, Hayashi, & Shinoda, ; Hsiao et al, ; Karadsheh, Turfe, & Komorowska‐Timek, ; Livaoglu, Karacal, Bektas, & Bahadir, ; Menick & Salibian, ; Moore, Montgomery, McMahon, & Sheikh, ; Moore, Strome, Kasperbauer, Sherris, & Manning, ; Nisanci, Turegun, Er, & Sengezer, ; Senda et al, ; Seth, Revenaugh, Scharpf, Shipchandler, & Fritz, ; Swartz, ; Upton, Ferraro, Healy, Khouri, & Merrell, ; Wehrens, Hawinkels, Fresow, Van der Hulst, & Boeckx, ; Winslow, Cook, Burke, & Wax, ; Zhou, He, Liao, & Yao, ). Study design consisted of 13 case reports and 9 case series (Table ).…”

Section: Resultsmentioning

confidence: 99%

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

et al. 2019

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Background: Restoration of nasal lining is essential in reconstruction of subtotal/total nasal defects. When local flaps are inadequate, a microvascular flap should be used. The purpose of this scoping review is to map the literature and identify the described flap options for subtotal/total nasal reconstruction. Further to that, we will summarize the stated advantages and disadvantages, evaluate functional and esthetic outcomes, and appraise the current body of literature. Methods: An electronic literature search was completed. Studies required adult patients with subtotal/total nasal defects and lining reconstruction with microvascular free flap. Two independent reviewers completed screening and data extraction. Flap characteristics, advantages, disadvantages, functional and esthetic outcomes were reviewed. Two independent reviewers evaluated study quality. Results: Of 305 initial articles, 22 studies were included (13 case reports, 9 case series) accounting for 65 flaps. Microvascular flaps varied by composition and anatomical location. For functional outcome, 13 studies used clinical exam by surgeon, 5 reported patient being satisfied, 3 studies used endoscopy, and 1 study used nasometry. Assessing esthetic outcome, 13 studies used clinical exam by surgeon, 5 studies reported patient being satisfied, 1 study used patientreported outcome measures, and 16 studies included photos. Study quality (modified CARE and PROCESS checklists) was deemed poor. Quality of available evidence was level IV.Conclusions: Microvascular free flaps for nasal reconstruction, confer an overall satisfactory functional and esthetic outcome. All studies lack a systematic and comprehensive approach to assessing and reporting these outcomes. Future research should provide objective assessment and utilize patient reported outcome measures.

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“…The angular vessels are likely best suited for use in reconstructing defects involving the nose and nasal lining (eg, free anterolateral thigh fascia lata free flap for nasal lining 8 ), midface (eg, fibula for midface 9 ), and palate and upper oral cavity owing to the close proximity. The results of the present study show that the angular artery diameter is comparable to that found in anatomic studies evaluating sels provide the reconstructive surgeon another tool with which to manage challenging facial defects in specific clinical situations.…”

Section: Discussionmentioning

confidence: 99%

Use of Angular Vessels in Head and Neck Free-Tissue Transfer

Haffey

McBride

Fritz

2014

JAMA Facial Plast Surg

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The angular artery, its perforating branches, and their zones of tissue perfusion have been described extensively for facial reconstruction. Various cutaneous and mucosal flaps with either anterograde or retrograde perfusion play an important role in facial and oral reconstruction. However, these flaps share the limitations of pedicled nature and donor-site intolerance. Free-tissue transfer (FTT) has transformed capabilities and outcomes in head and neck reconstruction. While less constrained by tissue volume and subtype, FTT has its own limitations, including pedicle reach for anastomosis to inflow and outflow vasculature in upper face reconstruction. The angular vessels, owing to their relatively high central location and accessibility via a camouflaged nasolabial fold incision, may have value in midface and nasal reconstruction.OBJECTIVES To detail a technique for consistently locating the angular vessels while preserving the integrity of adjacent neuromuscular structures and to evaluate the caliber and consistency of the angular artery and vein for their usability in microvascular anastomosis. DESIGN AND SETTINGWe conducted a PubMed literature search for the terms angular artery, melolabial flap, nasolabial flap, retroangular flap, and any associations with FTT. We also performed 26 anatomic cadaveric dissections on 13 fresh cadavers to evaluate the angular arteries and veins. MAIN OUTCOMES AND MEASURESVessel caliber, length, and variability were analyzed and utility for use in FTT was assessed. A total of 26 angular arteries and 26 angular veins were included in the analysis. Anatomic relationships were used to develop a surgical schema for dissection and isolation of the angular vessels specifically for FTT. RESULTSThe angular vessels have consistent anatomic relationships facilitating localization and have a consistent caliber amenable to use in microvascular FTT. The mean (SD) artery diameter was 2.34 (0.67) mm prior to dilation and 3.21 (0.87) mm after dilation. The diameters of the vein before and after dilation were 3.57 (0.53) mm and 6.40 (0.81) mm, respectively. There was no statistical difference between the vessels on the right and left sides. CONCLUSIONS AND RELEVANCEWe describe for the first time the anatomic cadaveric dissection and analysis of the angular arteries and veins specifically to determine compatibility with regard to FTT. We found good FTT compatibility.LEVEL OF EVIDENCE NA.

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Free Anterolateral Thigh Fascia Lata Flap for Complex Nasal Lining Defects

Cited by 50 publications

References 14 publications

Short‐stay hospital admission after free tissue transfer for head and neck reconstruction

Short‐stay hospital admission after free tissue transfer for head and neck reconstruction

Microvascular lining options for subtotal and total nasal reconstruction: A scoping review

Use of Angular Vessels in Head and Neck Free-Tissue Transfer

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