True Functional Reconstruction of Total or Subtotal Glossectomy Defects Using a Chimeric Anterolateral Thigh Flap With Both Sensorial and Motor Innervation

Özkan, Özlenen; Özkan, Ömer; Derin, Alper Tunga; Bektas, Gamze; Cinpolat, Ani; Duymaz, Ahmet; Mardini, Samir; Cigna, Emanuele; Chen, Hung-Chi

doi:10.1097/sap.0b013e3182a6add7

Cited by 35 publications

(29 citation statements)

References 18 publications

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“…Most studies focus on the importance of using thick, oversized flaps to create lasting volume in the neotongue. 19 The desired long-term properties to promote swallowing and speech recovery include a bulky, protuberant form. Some authors have also incorporated laryngeal suspension 10,11 and sensory and motor re-innervation to promote long-term function.…”

Section: Discussionmentioning

confidence: 99%

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Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

et al. 2019

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Objective To determine the two‐dimensional (2D) characteristics of flaps necessary to create three‐dimensional (3D) tongue anatomy. Methods Dissection of 11 fresh, nonpreserved human cadavers was performed. Six defects in each were created: total tongue, total oral tongue, hemiglossectomy, oral hemiglossectomy, total base of tongue, and hemi‐base of tongue. The resections were debulked to create flat, 2D mucosal flaps. The dimensions and shapes of these flaps were determined. Results Each specimen showed consistent dimensions and geometry between cadavers. The total tongue was pear‐shaped, the total oral tongue was egg‐shaped, the oral hemi‐tongue was bullet‐shaped, the hemi‐tongue resembled a dagger, the total base of tongue was rectangular, and the hemi‐base of tongue was hour‐glass shaped. Conclusion Typical dimensions and shapes of common tongue defects were determined. It is conceivable that customizing reconstructive flaps based on these data will increase the accuracy of neo‐tongue reconstruction, and thus, improve functional outcomes.

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Section: Discussionmentioning

confidence: 99%

“…The shape is essentially an extended bullet with semicircular ridge posteriorly to approximate the posterior floor of mouth. 11,19,28 Thus, it is emphasized that the volume of the flap must be overcorrected under the designed shape. Here, the mean dimensions were~11 × 3 cm.…”

Section: Discussionmentioning

confidence: 99%

Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

et al. 2019

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“…Oral bölgedeki geniş defektlerde ya da dil rekonstrüksiyonunda ALT veya kemik defektinin dahil olduğu olgularda fibula osteokutanöz flep kullanılabilir (24)(25)(26). Skalpte geniş defektlerde lattisimus dorsi ya da ALT uygun olabilir (27,28).…”

Section: Discussionunclassified

“…Akd Tıp D / Akd Med J / 2017; 1: 15-24 26 hastaya anterolateral uyluk(ALT) flebi, 20 hastaya fibula osteokutanöz ve 2 hastaya osseoz fibula flebi, 14 hastaya latissimus dorsi kas flebi, 7 hastaya grasillis kas flebi ve 1 hastaya jejenum flebi ile baş ve boyun bölgesinde rekonstrüksiyon gerçekleştirildi (Tablo V).…”

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Microvascular Complications in Head and Neck Defects Reconstructed with Free Flaps

Özkan¹,

Ubur²,

Yaprak³

et al. 2017

Akd Med J

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ÖZAmaç: Baş ve boyun bölgesindeki defektlerin rekonstrüksiyonunda mikrocerrahi yöntem kullanma sıklığının artması ve buna bağlı olarak cerrahi deneyimde ilerleme gözlenmesi nedeniyle arter ve ven yetmezliğine bağlı revizyona alınan fleplerin oranında düşme gözlenmektedir, ancak kullanım sık-lığının artması nedeniyle yetmezlik tespit edilen olgu sayısı artmaktadır. Çalışmanın amacı, baş ve boyun defektlerinde serbest flep kullanımından sonra görülen arteryal ve venöz yetmezlik nedenlerini saptamak ve serbest flep uygulanan hastaların revizyon üzerine demografik özelliklerini araştırmaktır. ABSTRACTObjective: Because of increased frequency of use of microsurgical methods in head and neck defects, the number of cases in which insufficiency has been detected is going up, although the rate of revision due to arterial and venous insufficiency has decreased. The purpose of this study was to determine the causes of arterial and venous insufficiency after free flap used in head and neck defects and to investigate the effects of the demographic characteristics of the patients with free flaps on revision. Material and Methods: Between 2013 and 2016, 72 patients who were reconstructed with free flaps in the head and neck region defects were evaluated. 26 patients were reconstructed due to oral cavity, tongue root, and mandibular defects; 17 patients due to maxilla and orbital defects; 19 patients due to lip defects; and 10 patients due to problems related to the scalp and upper part of the face. 26 patients underwent anterolateral thigh (ALT) flap; 22 patients fibular flap; 14 patients latissimus dorsi flap; 7 patients gracilis muscle flap and 1 patient jejunal flap. Results: In 66 patients, recovery was completed without any problem. In 6 patients flaps were revised due to arterial or venous insufficiency. Total loss of two flaps and one partial flap necrosis were observed. Conclusion: Circulatory failure may occur after free flap transfer. With good follow-up, flap failures can be detected early and the problems that cause failure can be resolved. In wide head and neck defects, free flaps should be considered as the first choice because of the good functional and aesthetic results.

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“…It can be harvested with a muscle cuff or with fascia according to patients' needs [27]. This flap can be raised with a muscle cuff from vastus lateralis muscle as a chimeric flap [28] or with fascia lata for different reconstructive purposes [29].…”

Section: The Anterolateral Thigh Flapmentioning

confidence: 99%

Perforator Flaps: Principles and Techniques

Tenekeci¹

2018

Issues in Flap Surgery

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Evolution of flaps has continued after the introduction of fasciocutaneous and musculocutaneous flaps. Perforator flaps have evolved, and they have provided many new flaps with new pedicles all over the body presenting important advantages. Better understanding of vascular anatomy and pattern of skin circulation has become possible by numerous cadaveric studies. As a result, widespread use of perforator flaps, either pedicled or free, has become possible. Perforator flaps have provided freedom of flap design with over 350 perforators all over the body, reliability, and reduced donor site morbidity. However, success begins with planning and continues with operative procedure. Here, in this relatively new field of reconstructive surgery, the following are discussed: the correct planning of perforator flaps, microanatomy of perforators, and what to do during the operation based on previous reports. Lastly, some brief information and examples of perforator-based workhorse flaps are given.

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True Functional Reconstruction of Total or Subtotal Glossectomy Defects Using a Chimeric Anterolateral Thigh Flap With Both Sensorial and Motor Innervation

Abstract: The results of this reconstructive option were satisfactory in terms of motor function and sensitive assessment of the neotongue. This technique is strongly recommended for patients with total or subtotal glossectomy.

Cited by 35 publications

References 18 publications

Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

Microvascular Complications in Head and Neck Defects Reconstructed with Free Flaps

Perforator Flaps: Principles and Techniques

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