Pedicled Temporoparietal Galeal Flap for Reconstruction of Intraoral Defects

Pinto, Fábio Roberto; Magalhães, Roberto; Capelli, Fábio de Aquino; Brandão, Lenine Garcia; Kanda, Jossi Ledo

doi:10.1177/000348940811700805

Cited by 29 publications

(14 citation statements)

References 22 publications

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“…For these reasons, pedicled flaps continue to play an important role in many institutions worldwide, [3][4][5][6] with special regard to cancer treatment centers in developing and emerging countries. Among these flaps, pectoralis major myocutaneous flaps (PMMFs) are undoubtedly the most reliable and versatile type of flap and are still considered to be the "workhorse" in head and neck reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

et al. 2010

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CONTEXT AND OBJECTIVE: Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection. DESIGN AND SETTING:Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC). METHODS:Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion.RESULTS: There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (P = 0.02) and with reconstruction failure (P < 0.001). Previous oncological treatment negatively influenced the reconstruction success (P = 0.04). CONCLUSIONS:Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.RESUMO CONTEXTO E OBJETIVO: Retalhos pediculados têm grande importância nos centros de tratamento do câncer, principalmente em países emergentes e em desenvolvimento. O objetivo deste trabalho foi identificar fatores que determinam complicações e influenciam no resultado final das reconstruções com retalho miocutâneo de peitoral maior (RMPM) no reparo de defeitos cirúrgicos por ressecções de cânceres de cabeça e pescoço. TIPO DE ESTUDO E LOCAL: Estudo transversal no Hospital de Ensino Padre Anchieta da Faculdade de Medicina do ABC.MÉTODOS: Dados de 58 pacientes submetidos a reconstruções de defeitos de cabeça e pescoço com RMPM foram revisados. O resultado final da reconstrução (sucesso ou falha) e as complicações observadas foram avaliados de acordo com a idade do paciente, área reconstruída, estágio da doença, tratamento oncológico prévio e necessidade de transfusão sanguínea.RESULTADOS: Não houve perda total de retalho. A taxa de sucesso da reconstrução foi de 93,1%. Complicações relacionadas ao retalho ocorreram em 43,1% dos casos e 50% delas foram considerados como complicações maiores. A maioria das complicações foi tratada com sucesso. Os defeitos originados da hipofaringe relacionaram-se com o desenvolvimento de complicações maiores (P = 0,02) e falhas na reconstrução (P < 0,001). Tratamento oncológico prévio influenciou negativamente no sucesso da reconstrução (P = 0,04).CONCLUSÕES: Como os fatores de risco...

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Section: Introductionmentioning

confidence: 99%

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

et al. 2010

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“…Kelly and colleagues successfully used the galeal aponeurosis with the frontalis muscle to obliterate a frontal sinus in 31 patients. Pinto and colleagues transposed the temporoparietal galeal flap to a distant area for oral cavity and oropharynx reconstruction in six consecutive cases. A deeper plane flap, the subgaleal‐periosteal turnover flap, has also been described previously.…”

Section: Discussionmentioning

confidence: 99%

Turnover Superficial Temporal Fascia Flap: A Galeopericranial-Based Random Flap for Coverage of Vertex Defects on the Scalp

Tan

2013

Dermatologic Surgery

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“…The reported rates of recurrence vary from 5% to 63%, and the rates can be reduced by canal-wall-down procedures. 9) A combined transmastoid/middle fossa approach facilitates excellent visualization of and access to the entire floor of the middle cranial fossa from the rostral and caudal routes. Therefore, the cholesteatoma epithelium can be completely removed from the surface of the dura mater and petrous bone under a wide surgical view.…”

Section: Discussionmentioning

confidence: 99%

Combined Transmastoid/Middle Fossa Approach for Intracranial Extension of Middle Ear Cholesteatoma

Tabuchi

Yamamoto

Akutsu

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A retrospective review was performed of patients treated for middle ear cholesteatoma with bone defects of the skull base via a combined transmastoid/middle fossa approach at the University of Tsukuba Hospital from 2006 through 2011 to determine the safety and effectiveness of a combined transmastoid/middle fossa approach for the treatment of cholesteatoma involving the middle cranial fossa. The bone defects of the skull base were reconstructed with a galeal flap pedicled with a parietal branch of the superficial temporal artery and an autologous bone flap. The clinical and radiological data were analyzed. This series included 8 patients (6 men and 2 women) with a mean age of 46.3 years (range 10-67 years). One of the patients preoperatively exhibited meningoencephalocele of the middle fossa skull base, and in the remaining 7 patients, petrous bone involvement such as involvement of the supralabyrinthine cells was observed. The cholesteatoma lesion was totally removed and inner ear function preserved in all the patients. Cerebrospinal fluid leakage was observed in 1 patient during and after the surgery. Neither meningitis nor recurrence was observed in any patient during the follow-up periods (mean 29.4 months, range 6-64 months). The combined transmastoid/middle fossa approach allowed complete removal of cholesteatoma with middle cranial fossa involvement while preserving hearing and preventing postoperative cerebrospinal fluid leakage and meningitis.

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Pedicled Temporoparietal Galeal Flap for Reconstruction of Intraoral Defects

Abstract: The pedicled temporoparietal galeal flap is another option for selected cases of reconstruction of intraoral defects--mainly those located in the posterior oral cavity and oropharynx, in which thin and pliable tissues are usually required.

Cited by 29 publications

References 22 publications

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

Turnover Superficial Temporal Fascia Flap: A Galeopericranial-Based Random Flap for Coverage of Vertex Defects on the Scalp

Combined Transmastoid/Middle Fossa Approach for Intracranial Extension of Middle Ear Cholesteatoma

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