The early use of a perforator flap of the lateral lower limb in maxillofacial reconstructive surgery

Wolff, Klaus; Kesting, Marco; Thurmüller, Petra; Böckmann, Roland; Hölzle, Frank

doi:10.1016/j.ijom.2006.02.017

Cited by 14 publications

(8 citation statements)

References 27 publications

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“…This flap gradually overtook the radial forearm flap to become the workhorse flap (Demirkan et al, ; Kimata et al, ; Koshima et al, ; Shieh et al, ; Wei et al, ), particularly in the eastern world where obesity was less prevalent. The peroneal flap, first described by Yoshimura, Imura, Shimamura, Yamauchi, & Nomura, (), was reported as a viable and versatile option for a variety of soft tissue defects (Huang, Liu, Chen, & Yang, ; Ikeda, Yokoyama, Okada, Tomita, & Nagayama, ; Lin, Liu, Chen, & Yang, ; Liu and Yang, ; Loeffelbein, Holzle, & Wolff, ; Wolff & Stellmach, ; Wolff, ; Wolff, Holzle, & Nolte, ; Wolff, Kesting, Thurmuller, Bockmann, & Holzle, ; Yang, Leung, & Chen, ). Despite its thinness, minor donor site morbidity, and easy two‐team approach, there had been a pushback on adopting this flap as one of the workhorse flaps, most likely because of its steeper learning curve.…”

Section: Discussionmentioning

confidence: 99%

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

et al. 2017

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“…Dies stellt die klassische Indikation für die Verwendung eines fi ligranen fasziokutanen Radialislappens dar [ 5 , 16 ] . Die alternative Verwendung anterolateraler Oberschenkellappen ist zwar mit keinem Hebedefekt verbunden, der Muskel muss aber in erheblichem Ausmaß ausgedünnt werden, was bei diesem Perforatorlappen Risiken für die Lappenperfusion birgt [ 17 ] . (1) Mukoperiostlappen vom Hartgaumen [ 11 ] (2) Muskelfaszienlappen (M. masseter [ 12 ] , M. constrictor pharyngeus superior [ 13 ] , M. temporalis [ 14 ] , neurovaskuläre infrahyoidale Lappen [ 15 ] ) Stufe 3 freier Gewebetransfer:…”

Section: Rubrikherausgeber H Riechelmann Innsbruckunclassified

“…(1) Radialislappen [ 5 , 16 , 21 ] (2) lateraler Oberarmlappen [ 18 ] (3) anterolateraler Oberschenkellappen [ 17 ] …”

Section: Rubrikherausgeber H Riechelmann Innsbruckunclassified

Funktionelle Weichgaumenrekonstruktion mit Radialislappen

Strieth

Stöver²

2013

Laryngo-Rhino-Otol

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Oropharyngeal cancer of the soft palate is a therapeutic challenge. This is due to crucial importance of velopharyngeal competence for articulation and swallowing. Patient counseling must present the whole therapeutic spectrum in order to receive informed consent. Basically, in primary therapy of oropharyngeal cancer multimodal concepts have to be considered including surgical resection and radiochemotherapy. With regard to the occasional difficulties predicting the functional outcome after primary therapy the ladder of reconstructive options has to be discussed a priori. Among numerous pedicled flaps the radial forearm free flap nowadays belongs definitely in the surgical armoury, which offers almost ideal reconstructive possibilities after extensive resections. This implies some additional aspects in pre- and postoperative workup that are reviewed in this article.

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“…Discussion Various local and free flap has been used for reconstruction of partial tongue defects with its obvious donor site problems, like less pliable skin and not so adequate tissue from local flaps and sacrificing a important artery as in radial forearm flap serves as the work horse in reconstruction of partial tongue defects, Concept of super microsurgery was popularized by Japanese in 1980s and the concept of angiosome proposed by Taylor [2]. These flaps can be raised from various parts of the body like thigh, abdomen, forearm, buttock [3]. We describe our experience of perforator based Peroneal flap harvested from lower leg for the reconstruction of tongue defect (Fig.…”

Section: Introductionmentioning

confidence: 99%

Perforator Peroneal Artery Flap for Tongue Reconstruction

Chauhan

Chavre

Chandrashekar

et al. 2016

J. Maxillofac. Oral Surg.

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Introduction Reconstruction has evolved long way from primary closure to flaps. As time evolved, better understanding of vascularity of flap has led to the development of innovative reconstructive techniques. These flaps can be raised from various parts of the body for reconstruction and have shown least donor site morbidity. We use one such peroneal artery perforator flap for tongue reconstruction with advantage of thin pliable flap, minimal donor site morbidity and hidden scar. Materials and Methods Our patient 57yrs old lady underwent wide local excision with selective neck dissection. Perforators are marked about 10 and 15 cm inferiorly from the fibular head using hand held Doppler. Leg is positioned in such a way to give better exposure during dissection of the flap and flap is harvested under a tourniquet with pressure kept 350 mm Hg. The perforator is kept at the eccentric location, so as to gain length of the pedicle. Skin incison is placed over the peroneal muscle and deepened unto the deep facia, then the dissection is continued over the muscle and the perforator arising from the lateral septum. The proximal perforator about 10 cm from the fibular head is a constant perforator and bigger one, which is traced up to the peroneal vessel. We could get a 6 cm of pedicle length. Finally the flap is islanded on this perforator and the pedicle is ligated and flap harvested. Anastamosis was done to the ipsilateral side to facial vessels. The donor site is closed primarily and in the upper half one can harvest 5 cm width flap without requiring a skin graft along with a length of 8 to 12 cm. Discussion Various local and free flap has been used for reconstruction of partial tongue defects with its obvious donor site problems, like less pliable skin and not so adequate tissue from local flaps and sacrificing a important artery as in radial forearm flap serves as the work horse in reconstruction of partial tongue defects, Concept of super microsurgery was popularized by Japanese in 1980s and the concept of angiosome proposed by Taylor paved the way for development of new flaps. True perforator flaps are those where the source vessel is left undisturbed and overlying skin flap is raised. Yoshimura proposed cutaneous flap could be raised from peroneal artery (Br J Plast Surg 42:715-718, 1989). Wolff et al. (Plast Reconstr Surg 113:107-113, 2004) first used perforator based peroneal artery flap for oral reconstruction. Location of perforators vary, hence pre operative localisation can be done by ultrasound doppler, CT angio or MR angiography. Disadvantages over radial flap include varying anatomic location of perforators, need for imaging and difficult dissection of delicate vessels through muscles and hence a learning curve. Our patient had an arterial thrombus within few hours post-operatively which was successfully salvaged with immediate re-exploration and re-anastomosis of artery. Post-operative healing was uneventful and donor site was closed primarily without the need for graft. Conclusions Perforator ...

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The early use of a perforator flap of the lateral lower limb in maxillofacial reconstructive surgery

Cited by 14 publications

References 27 publications

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

Funktionelle Weichgaumenrekonstruktion mit Radialislappen

Perforator Peroneal Artery Flap for Tongue Reconstruction

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The early use of a perforator flap of the lateral lower limb in maxillofacial reconstructive surgery

Cited by 14 publications

References 27 publications

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients—A sonographic study

Funktionelle Weichgaumen­rekonstruktion mit Radialislappen

Perforator Peroneal Artery Flap for Tongue Reconstruction

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Funktionelle Weichgaumenrekonstruktion mit Radialislappen