Abstract
Objectives: Anterolateral thigh flap (ALT) is an useful flap for head and neck reconstruction, but the variable perforators may limit its applications. Our goal was to clarify the benefits of preoperative CT angiography (CTA) in mapping of free ALT perforators for reconstruction of cheek through-and-through defects. Method: We retrospectively reviewed 32 patients undergoing reconstruction of through-and-through cheek defects with a free ALT flap between February 2005 and July 2009. These patients were divided into two groups. Group I (N = 17): the ALT flap was designed based on the traditional handheld Doppler probe. Group II (N = 15): preoperative imaging with CTA was used to map the perforator's number, size and variations. Surgical results were evaluated for both major and minor complications, as with the operation time, length of hospital stay and donor-site morbidity. Results: Overall flap survival was 96.88% (31 of 32 flaps). The use of preoperative CTA was associated with a significant reduction in major surgical complications, length of surgery and the need for a secondary debulking procedure (p <0.05). There was no difference in minor complication and donor-site morbidity. Conclusions: The use of CTA for preoperative navigation of ALT flap for cheek reconstruction is associated with improved operative outcomes. Detailed data from images allow the surgeon to interpret any anatomical variations, choosing the exact suitable thigh, facilitate flap design, and greatly reduce major postoperative complications.
| Original language | English |
|---|---|
| Pages (from-to) | 633-638 |
| Number of pages | 6 |
| Journal | Journal of Cranio-Maxillofacial Surgery |
| Volume | 39 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Dec 2011 |
| Externally published | Yes |
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Keywords
- Anterolateral thigh flap
- Cheek through-and-through defect
- CT angiography
- Oral cavity cancer
- Oromandibular defect reconstruction
ASJC Scopus subject areas
- Oral Surgery
- Otorhinolaryngology
- Surgery
Cite this
Comparison of surgical result of anterolateral thigh flap in reconstruction of through-and-through cheek defect with/without CT angiography guidance. / Liu, Shao Cheng; Chiu, Wen Kuan; Chen, Shih Yi; Lee, Tzu Peng; Wang, Hsing Won; Chen, Shyi Gen.
In: Journal of Cranio-Maxillofacial Surgery, Vol. 39, No. 8, 12.2011, p. 633-638.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of surgical result of anterolateral thigh flap in reconstruction of through-and-through cheek defect with/without CT angiography guidance
AU - Liu, Shao Cheng
AU - Chiu, Wen Kuan
AU - Chen, Shih Yi
AU - Lee, Tzu Peng
AU - Wang, Hsing Won
AU - Chen, Shyi Gen
PY - 2011/12
Y1 - 2011/12
N2 - Objectives: Anterolateral thigh flap (ALT) is an useful flap for head and neck reconstruction, but the variable perforators may limit its applications. Our goal was to clarify the benefits of preoperative CT angiography (CTA) in mapping of free ALT perforators for reconstruction of cheek through-and-through defects. Method: We retrospectively reviewed 32 patients undergoing reconstruction of through-and-through cheek defects with a free ALT flap between February 2005 and July 2009. These patients were divided into two groups. Group I (N = 17): the ALT flap was designed based on the traditional handheld Doppler probe. Group II (N = 15): preoperative imaging with CTA was used to map the perforator's number, size and variations. Surgical results were evaluated for both major and minor complications, as with the operation time, length of hospital stay and donor-site morbidity. Results: Overall flap survival was 96.88% (31 of 32 flaps). The use of preoperative CTA was associated with a significant reduction in major surgical complications, length of surgery and the need for a secondary debulking procedure (p <0.05). There was no difference in minor complication and donor-site morbidity. Conclusions: The use of CTA for preoperative navigation of ALT flap for cheek reconstruction is associated with improved operative outcomes. Detailed data from images allow the surgeon to interpret any anatomical variations, choosing the exact suitable thigh, facilitate flap design, and greatly reduce major postoperative complications.
AB - Objectives: Anterolateral thigh flap (ALT) is an useful flap for head and neck reconstruction, but the variable perforators may limit its applications. Our goal was to clarify the benefits of preoperative CT angiography (CTA) in mapping of free ALT perforators for reconstruction of cheek through-and-through defects. Method: We retrospectively reviewed 32 patients undergoing reconstruction of through-and-through cheek defects with a free ALT flap between February 2005 and July 2009. These patients were divided into two groups. Group I (N = 17): the ALT flap was designed based on the traditional handheld Doppler probe. Group II (N = 15): preoperative imaging with CTA was used to map the perforator's number, size and variations. Surgical results were evaluated for both major and minor complications, as with the operation time, length of hospital stay and donor-site morbidity. Results: Overall flap survival was 96.88% (31 of 32 flaps). The use of preoperative CTA was associated with a significant reduction in major surgical complications, length of surgery and the need for a secondary debulking procedure (p <0.05). There was no difference in minor complication and donor-site morbidity. Conclusions: The use of CTA for preoperative navigation of ALT flap for cheek reconstruction is associated with improved operative outcomes. Detailed data from images allow the surgeon to interpret any anatomical variations, choosing the exact suitable thigh, facilitate flap design, and greatly reduce major postoperative complications.
KW - Anterolateral thigh flap
KW - Cheek through-and-through defect
KW - CT angiography
KW - Oral cavity cancer
KW - Oromandibular defect reconstruction
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U2 - 10.1016/j.jcms.2011.01.004
DO - 10.1016/j.jcms.2011.01.004
M3 - Article
VL - 39
SP - 633
EP - 638
JO - Journal of Cranio-Maxillo-Facial Surgery
JF - Journal of Cranio-Maxillo-Facial Surgery
SN - 1010-5182
IS - 8
ER -