Volume 8, Issue 1 (1-2019)                   wjps 2019, 8(1): 103-107 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Weinand C, Dittes C. Soft Tissue Mandibula and Tongue Reconstruction Using A Suprafascial, Folded, Deepithelialized Antero-Lateral Thigh Perforator Free Flap. wjps. 2019; 8 (1) :103-107
URL: http://wjps.ir/article-1-452-en.html
Department of Plastic and Reconstructive Surgery, Hand Surgery, Dietrich-Bonhoeffer-Klinikum Neubrandenburg, Germany
Abstract:   (1062 Views)

Head and neck squamous cell carcinoma (HNSCC) is the most frequent carcinoma of the head and neck region.  For coverage of an entire resected mandible with floor of the mouth, 3/4 of the tongue and soft tissue of cheeks and neck bony reconstruction of the mandible and soft tissue reconstruction of tongue, cheeks and a neck large flap are needed. A patient with a superinfected T4 HNSCC was presented to our outpatient clinic. Complete resection of the mandible, bilateral neck dissection and 3/4 resection of the tongue were performed. A complex reconstruction using two free flaps was not feasable, so a large, folded, suprafascial Antero Lateral Thigh Perforator (ALTP) flap for immediate soft tissue reconstruction was used. Because of the anatomy, no reconstruction plate was inserted. On postop day 11, an understandable speaking was possible using a speach canula. Swallowing was possible without regurgitation. Eight months postoperatively, the patients mimic and closure of the mouth were satisfactory. The flap was viable throughout the entire time. It was shown that the suprafascial ALTP flap was a versatile part in the armamentarium for complex mandible soft tissue reconstruction.

Full-Text [PDF 1029 kb]   (939 Downloads)    
Type of Study: case report | Subject: Special
Received: 2018/10/22 | Accepted: 2019/03/13 | Published: 2019/03/13

References
1. Chen GS, Chen CH. [A study on survival rates of oral squamous cell carcinoma]. Kaohsiung J Med Sci 1996;12:317-25.
2. Lutz BS, Wei FC. Microsurgical workhorse flaps in head and neck reconstruction. Clin Plast Surg 2005;32:421-30, vii. doi: 10.1016/j.cps.2005.02.006. [DOI:10.1016/j.cps.2005.02.006]
3. Wong CH, Wei FC. Microsurgical free flap in head and neck reconstruction. Head Neck 2010;32:1236-45. doi: 10.1002/hed.21284. [DOI:10.1002/hed.21284]
4. Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, Glisson B, Trotti A, Ridge JA, Chao C, Peters G, Lee DJ, Leaf A, Ensley J, Cooper J. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091-8. doi: 10.1056/NEJMoa031317. [DOI:10.1056/NEJMoa031317]
5. Wong CH, Wei FC. Microsurgical free flap in head and neck reconstruction. Head Neck 2009;32:1236-45. doi: 10.1002/hed.21284. [DOI:10.1002/hed.21284]
6. Vos JD, Burkey BB. Functional outcomes after free flap reconstruction of the upper aerodigestive tract. Curr Opin Otolaryngol Head Neck Surg 2004;12:305-10. doi: 10.1097/01.moo.0000130573.25903.b3. [DOI:10.1097/01.moo.0000130573.25903.b3]
7. Yu P. Reinnervated anterolateral thigh flap for tongue reconstruction. Head Neck 2004;26:1038-44. doi: 10.1002/hed.20106. [DOI:10.1002/hed.20106]
8. Kimata Y, Sakuraba M, Hishinuma S, Ebihara S, Hayashi R, Asakage T, Nakatsuka T, Harii K. Analysis of the relations between the shape of the reconstructed tongue and postoperative functions after subtotal or total glossectomy. Laryngoscope 2003;113:905-9. doi: 10.1097/00005537-200305000-00024. [DOI:10.1097/00005537-200305000-00024]
9. Disa JJ, Pusic AL, Hidalgo DH, Cordeiro PG. Simplifying microvascular head and neck reconstruction: a rational approach to donor site selection. Ann Plast Surg 2001;47:385-9. [DOI:10.1097/00000637-200110000-00004]
10. Peng X, Mao C, Yu GY, Guo CB, Huang MX, Zhang Y. Maxillary reconstruction with the free fibula flap. Plast Reconstr Surg 2005;115:1562-9. doi: 10.1097/01.prs.0000160691.63029.74. [DOI:10.1097/01.PRS.0000160691.63029.74]
11. Deutsch M, Kroll SS, Ainsle N, Wang B. Influence of radiation on late complications in patients with free fibular flaps for mandibular reconstruction. Ann Plast Surg 1999;42:662-4. doi: 10.1097/00000637-199906000-00014. [DOI:10.1097/00000637-199906000-00014]
12. Hidalgo DA, Pusic AL. Free-flap mandibular reconstruction: a 10-year follow-up study. Plast Reconstr Surg 2002;110:438-49; discussion 50-1. doi: 10.1097/00006534-200208000-00010. [DOI:10.1097/00006534-200208000-00010]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


© 2020 All Rights Reserved | World Journal of Plastic Surgery

Designed & Developed by : Yektaweb