Free Peroneal Skin Flap for Oropharyngeal Reconstruction

Saitô, Hitoshi; Kimura, Yuichi; Tsuda, Gota; Fujieda, Shigeharu; Ohtsubo, Toshio; Saito, Takehisa; Yoshimura, Mitsuo

doi:10.1080/02844319950159613

Cited by 10 publications

(3 citation statements)

References 10 publications

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“…The lack of significant donor site complications, the availability of large quantities of pliable tissue, and the ability to use a 2-team approach has been sited by many as the major advantages. Many fasciocutaneous flaps have been described for the reconstruction of pharyngeal defects, including the radial forearm, 11 lateral thigh, 12 lateral arm, 13 scapular, 13 peroneal, 14 and the ulnar forearm. 15 The ALT has all the advantages of a fasciocutaneous reconstruction over the gastric pull-up or free jejunal transfer.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

et al. 2006

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“…The anatomy of the peroneal system also allows the harvesting of double-paddle peroneal tissue without the fibula, as successfully demonstrated by Saito, Yang, and Yoshimura and colleagues. [19][20][21] . These authors follow the cutaneous perforator branches to the peroneal vessels, and have largecaliber vessels for the microsurgical anatomoses.…”

Section: Discussionmentioning

confidence: 99%

Vasculature of the Peroneal Artery: An Anatomic Study Focused on the Perforator Vessels

2003

J reconstr Microsurg

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Based on the dissection of 20 fresh cadaver legs, the authors have further defined the vascular anatomy of the peroneal artery and its cutaneous perforator vessels. They identified a total of 95 cutaneous perforators of the peroneal artery greater then 0.3 mm in 20 legs. The average number of cutaneous perforators was 4.8 (range: three to seven) per leg. The cutaneous perforators were either musculocutaneous (34 percent) or septocutaneous (66 percent). The musculocutaneous perforators were found predominantly in the upper two-thirds of the lower leg; the septocutaneous perforators were located in the lower two-thirds of the leg. The external diameter of the cutaneous perforators at the posterior border of the fibula was 0.6 (range: 0.3 to 1.5) mm. The blood supply of the proximal fibula epiphysis and fibula head was found not to be in the vascular territory of the peroneal artery. These results are the basis of the established osteoseptocutaneous fibula transfer, the peroneal fasciocutaneous free flap, and the double-paddle peroneal tissue transfer that all require dissection of highly vascularized tissue adjacent to the fibula, in order to reach the peroneal vessels. These constant anatomic findings should encourage the surgeon to harvest skin flaps just to the level of the posterior border of the fibula, thereby creating perforator flaps based on the peroneal system.

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“…1 Fasciocutaneous free flaps overcome these disadvantages; moreover; the donor site can be selected according to the reconstruction and to patient requirements. A wide array of fasciocutanoeus flaps has been described for such reconstruction, including the radial forearm, 2 lateral arm, 3 scapular, 3 lateral thigh, 4 and peroneal 5 flaps; however, the radial forearm flap has become the most popular.…”

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confidence: 99%

Fasciocutaneous Free Flaps for Hypopharyngeal Reconstruction

Amin¹,

Bassiouny²,

Elsebai³

et al. 2002

J reconstr Microsurg

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Considerable controversy persists regarding the optimal technique for hypopharyngeal reconstruction. The ideal procedure should provide low mortality and morbidity, short hospitalization, a high success rate, few complications, and the greatest potential for neopharyngeal speech and deglutition. In this study, a variety of fasciocutaneous free flaps were used for reconstruction of the hypopharynx. Over a two-year period, fasciocutaneous flaps were used for reconstruction of pharyngoesophageal segments following total laryngopharyngectomies in 16 patients at The National Cancer Institute, Cairo University, Cairo, Egypt. Flap survival, recipient vessels used, and complications were examined. The ultimate functional and cosmetic outcomes of free flaps were compared. Of the 16 patients included in this study, nine were males, and seven were females. Free flaps used for reconstruction included the radial forearm (8), lateral arm (2), anterolateral thigh (3), and posterolateral thigh (3) flaps. Free flaps were successful in 15 patients. One patient had total flap loss. Salvage surgery was successful for one flap that developed venous congestion. Eleven patients received adjuvant radiation therapy. The commonly used recipient vessels were the small arteries of the neck and the external jugular vein. Five patients developed minor pharyngocutaneous fistulas that healed spontaneously. Six patients developed anastomotic line stricture. Donor-site morbidity was more significant with the radial forearm flap, compared to other flaps. Fasciocutaneous free flaps have a definite place in pharyngoesophageal reconstruction. The flap should be selected with reference to the type of the defect and patient obesity; however, donor-site morbidity should also be considered.

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Free Peroneal Skin Flap for Oropharyngeal Reconstruction

Cited by 10 publications

References 10 publications

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

Functional outcomes and donor site morbidity following circumferential pharyngoesophageal reconstruction using an anterolateral thigh flap and salivary bypass tube

Vasculature of the Peroneal Artery: An Anatomic Study Focused on the Perforator Vessels

Fasciocutaneous Free Flaps for Hypopharyngeal Reconstruction

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