Comparison of surgical result of anterolateral thigh flap in reconstruction of through-and-through cheek defect with/without CT angiography guidance

Shao Cheng Liu, Wen Kuan Chiu, Shih Yi Chen, Tzu Peng Lee, Hsing Won Wang, Shyi Gen Chen

Research output: Contribution to journalArticle

14 Citations (Scopus)

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 languageEnglish
Pages (from-to)633-638
Number of pages6
JournalJournal of Cranio-Maxillofacial Surgery
Volume39
Issue number8
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

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

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