Reconstruction of Through-and-Through Cheek Defects Involving the Oral Commissure, Using Chimeric Flaps from the Thigh Lateral Femoral Circumflex System

Huang, Wei-Chao; Chen, Hung-Chi; Jain, Vivek; Kilda, Morton; Lin, Yu-De; Cheng, Ming‐Huei; Lin, Shye-Horng; Chen, Yi-Chieh; Tsai, Feng-Chou; Wei, Fu‐Chan

doi:10.1097/00006534-200202000-00004

Cited by 23 publications

(33 citation statements)

References 8 publications

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“…In the setting of full thickness oromandibular defects, primary reconstruction with static lip support will provide continence, but not animation. When muscle is harvested with the flap, it is primarily used to recreate the buccal bulk (Huang et al, ; Jeng et al, ; Liu & Yang, ; Kuo et al, ). We identified six publications in peer review journals that address primary free functional muscle transfer for facial reanimation in the setting of oromandibular or cheek defects following trauma, oncological ablation or infection.…”

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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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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“…To solve the problems, many suspension techniques with a fascial sling have been suggested 4,5 . Most of them were methods to raise the lip and oral commissure upward.…”

Section: Discussionmentioning

confidence: 99%

Transverse fascial suspension with muscle bow traction: Advantages for full-thickness lip reconstruction involving the oral commissure using free flap

Sasaki¹,

Adachi²,

Sekido³

2012

Journal of Plastic, Reconstructive & Aesthetic Surgery

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SummaryLarge full-thickness oral defects involving the oral commissure continue to be a challenge for reconstructive surgeons.Although local flaps are the best option for full-thickness lip reconstruction, they are unavailable for large defects. In particular, recent advances in microsurgery have extended the available surgical options using free flaps, but for full-thickness large oral defects involving the oral commissure, it is still difficult to obtain good function and competence. The major disadvantages are the drooping and loosening of the reconstructed lip and the difficulty in restoring a natural oral commissure.We present 2 cases of lip reconstruction for full-thickness large defects involving the oral commissure in which free flaps with the muscle bow traction method were used to overcome these problems.In case 1, the lip was reconstructed with a free radial forearm-palmaris longus tendon composite flap. The tendon was sutured onto the orbicularis oris stumps.In case 2, the lip was reconstructed with a free anterolateral thigh flap including the fascia lata. A fascial strip in the flap was sutured to the residual orbicularis muscles. In each case, additional nonvascularized fascia lata was harvested 3 and suspended the reconstructed lip in transverse direction as a muscle bow traction method. Both patients achieved good oral competence without medial deviation of the oral commissure and were able to resume a regular diet without drooping and loosening of the reconstructed lip.For large full-thickness oral defects involving the oral commissure, transverse fascial suspension with muscle bow traction is useful for functional and cosmetic reconstruction.

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“…28 ALT flaps have advantages and versatile designing capabilities that make them suitable for the reconstruction of OMF defects in most clinical settings.…”

Section: Microvascular Free Flaps In Oral and Maxillofacial Reconstrumentioning

confidence: 99%

Microvascular Free Flaps in Oral and Maxillofacial Reconstruction following Cancer Ablation

Yadav

Shrestha

2017

J Nepal Health Res Council

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Microsurgical free flaps have become the first choice for reconstruction of oral and maxillofacial (OMF) defects after tumor resection. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery.Years of innovation in reconstructive microsurgery has given us a reasonably good number of excellent flaps. Tremendous work has been put into producing some exceptionally brilliant research articles, sometimes contradicting each other. This has led to the need for clarity in some areas in this field.This article reviews the most common microvascular free flaps (MFF) namely, radial forearm free flap (RFFF), anterolateral thigh flap (ALT) and free fibula flap (FFF) that are commonly used in OMF reconstruction. Since they can cater to almost all sizeable defects we come across after ablative surgery in the OMF region, they can aptly be titled as the workhorses of OMF reconstruction with regard to free flaps.

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Reconstruction of Through-and-Through Cheek Defects Involving the Oral Commissure, Using Chimeric Flaps from the Thigh Lateral Femoral Circumflex System

Cited by 23 publications

References 8 publications

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

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

Transverse fascial suspension with muscle bow traction: Advantages for full-thickness lip reconstruction involving the oral commissure using free flap

Microvascular Free Flaps in Oral and Maxillofacial Reconstruction following Cancer Ablation

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