Medial femoral condyle free flap in combination with paramedian forehead flap for total/subtotal nasal reconstruction: Level of evidence: IV (therapeutic studies)

Cherubino, Mario; Stocco, Chiara; Tamborini, Federico; Maggiulli, Francesca; Sallam, Davide; Corno, Martina; Bignami, Maurizio; Battaglia, Paolo; Valdatta, Luigi

doi:10.1002/micr.30532

Cited by 9 publications

(13 citation statements)

References 38 publications

(43 reference statements)

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“…1,12 This poses a limitation, as the SGA's shorter pedicle leads to higher risk of flap complications and failure, much like the iliac crest. 1,12,13,25,26 Laryngotracheal region 19,[32][33][34] Mandible 6,13,22,24,35,36 Maxillary alveolus 13,[19][20][21]37 Orbit 16,20 Palate 13,20 Other facial bony structures 19,[38][39][40] Problematic nonunions 6,20,36 Failed nonvascularized bone grafts 13,19,20,37 Recalcitrant defects 19,20,37 Osteoradionecrosis 13,16,20,22,24 Fig. 2.…”

Section: Discussionmentioning

confidence: 99%

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

Patel

Tipps

Bartlett

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background:The medial femoral condyle free flap serves as an attractive reconstructive option for small-to intermediate-sized bony defects. It is commonly applied in the extremities with limited reports in the head and neck. Methods: A systematic review of the literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: Seventeen articles met inclusion criteria, yielding 166 cases for analysis, with a majority of the cohort from a single study (n = 107; 64.4%). However, all included studies represented novel reconstructive sites and surgical indications. Flap components were described in 157 cases; periosteum was used only in four cases (2.5%), whereas all others are composed of cortical bone combined with periosteum, cancellous bone, and/or cartilage (97.5%). Additionally, a skin island was used in 43 cases (25.9%). Flap measurements were reported in 51 cases, averaging 4.5 ± 2.7 cm in length. Seven cases listed skin island dimensions, averaging 20.2 ± 12.8 cm 2 . The descending genicular artery was the primary pedicle employed (n = 162; 97.6%), while the superior medial genicular was used in the descending genicular artery's absence (n = 4; 2.4%). Descending genicular artery pedicle length from 15 reporting cases averaged 6.4 ± 1.2 cm. Successful reconstructions totaled 160 cases (96.4%). Recipient complications were seen in 16 cases (9.6%) with six constituting flap failures (3.6%). Donor site complications were minimal (n = 6; 3.6%); however, this included one major complication of femoral shaft fracture. Conclusion:The medial femoral condyle free flap is an effective reconstructive option for the head and neck due to its versatile nature, low complication profile at both recipient and donor site, ease of harvest, and two-team approach.

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Section: Discussionmentioning

confidence: 99%

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

Patel

Tipps

Bartlett

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…In addition, the MFC periosteum undergoes mucosalization or can support a skin graft for nasal lining, as in one of our cases. 17,18,23 The possibility for a chimeric flap with a skin island depends on the availability of skin perforators, which have tremendous anatomic variability. The descending genicular artery is the most common pedicle, as it is larger and longer than the superomedial genicular artery.…”

Section: Discussionmentioning

confidence: 99%

The Medial Femoral Condyle Flap: A Novel Versatile Tool for Complex Microvascular Maxillofacial Reconstruction

Ismail¹,

Kurlander²,

Lee³

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Summary: The medial femoral condyle flap is well-described for reconstruction of small bone defects of the upper and lower extremities. There are limited case reports of its use in other anatomic sites, particularly for reconstruction of complex head and neck defects. In the setting of previous radiation and contaminated fields, vascularized bone is generally preferred to bone grafts, cadaveric allografts, or synthetic implants. The authors present a case series of complex craniofacial defects involving the midface that were reconstructed using medial femoral condyle flaps, focusing on the type of defect and lessons learned from their early experience to promote awareness of this flap among microsurgeons, who may wish to consider the potential of this flap and incorporate its use into their armamentarium. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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“…At the same time, the disadvantages were the necessity for a two-stage procedure and difficulty harvesting the MFCFF. 12 …”

Section: Discussionmentioning

confidence: 99%

Outcomes Associated with Nasal Reconstruction Post-Rhinectomy: A Narrative Review

et al. 2022

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The face and the external nose define an individual's physical appearance. Nasal deformities can cause facial disfigurement along with unwanted psychological repercussions. Nasal deformities range in severity, with the most severe cases being indications for a rhinectomy, due to the complexity of the nasal defect. According to published literature, there is no consensus among otolaryngologists and plastic surgeons on which technique or flap use is preferred in terms of complications, aesthetic outcome, or patient satisfaction. The goal of this study is to provide a comprehensive analysis of published studies on nasal reconstruction following rhinectomy. Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for writing systematic reviews, a systematic review was conducted. Four databases were searched using a search strategy. These articles were then imported into the COVIDENCE software and went screening and thorough article review. After screening 2,237 articles, 23 studies were then extracted for data collection analysis. We collected data from 12 case series, 4 case studies, 1 prospective case series, and 4 retrospective chart review studies. The most commonly reported flaps were forehead flaps, superior extended nasal myocutaneous island, forearm free flaps, anterolateral thigh (ALT) free flap, medial femoral condyle free flap (n = 8), and zygomaticus implants (n = 6), and retained nasal prosthesis. Although not specifically indicated by a certain number, the most common indication for the rhinectomy was malignancy, followed by traumas, postsurgical complications, radionecrosis, and congenital nasal malformations.Although several donor flaps can be used after rhinectomy, we conclude that there is no preference over what flap has superior patient outcomes after analysis. As of current, there are no prospective studies that exist. Therefore, more research is necessary to determine the results of each flap.

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Medial femoral condyle free flap in combination with paramedian forehead flap for total/subtotal nasal reconstruction: Level of evidence: IV (therapeutic studies)

Cited by 9 publications

References 38 publications

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

Expanding Indications of the Medial Femoral Condyle Free Flap: Systematic Review in Head and Neck Reconstruction

The Medial Femoral Condyle Flap: A Novel Versatile Tool for Complex Microvascular Maxillofacial Reconstruction

Outcomes Associated with Nasal Reconstruction Post-Rhinectomy: A Narrative Review

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