The Facial Artery Perforator Flap as a New Option for Reconstruction of Intraoral Defects: Surgical Tips and Clinical Series

Horta, Ricardo; Barreiro, Diogo; Nascimento, Ricardo; Silva, Álvaro

doi:10.1097/scs.0000000000005347

Cited by 7 publications

(1 citation statement)

References 19 publications

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“…Horta et al [ 58 ] recently described the use of the facial artery perforator flap for osteoradionecrosis intraoral reconstruction. Though one of the patients had minor flap loss and dehiscence, no local recurrences were observed, and functional outcomes were satisfactory, so these cases were considered successes.…”

Section: Reconstruction Of An Orn-caused Mandibular Segmental Defect ...mentioning

confidence: 99%

The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

Huang

Wang

Gong

et al. 2023

Journal of Oncology

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Osteoradionecrosis (ORN) is described as a disease with exposed, nonviable bone that fails to heal spontaneously or by means of conservative treatment after radiotherapy in at least 3 months. Though traditional theories in the early stage including hypoxic-hypocellular-hypovascular and fibro-atrophic in addition to new findings such as ferroptosis were put forward to explain the mechanisms of the osteoradionecrosis, the etiology of ORN is still unclear. With the high rate of occurrence in the head and neck area, especially in the mandible, this disease can disrupt the shape and function of the irradiated area, leading to a clinical presentation ranging from stable small areas of asymptomatic exposed bone to severe progressive necrosis. In severe cases, patients may experience pain, xerostomia, dysphagia, facial fistulas, and even a jaw defect. Consequently, sequence therapy and sometimes extensive surgery and reconstructions are needed to manage these sequelae. Treatment options may include pain medication, antibiotics, the removal of sequesters, hyperbaric oxygen therapy, segmental resection of the mandible, and free flap reconstruction. Microanastomosed free-flaps are considered to be promising choice for ORN reconstruction in recent researches, and new methods including three-dimensional (3-D) printing, pentoxifylline, and amifostine are used nowadays in trying increase the success rates and improve quality of the reconstruction. This review summarizes the main research progress in osteoradionecrosis and reconstruction treatment of osteoradionecrosis with mandibular defect.

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Section: Reconstruction Of An Orn-caused Mandibular Segmental Defect ...mentioning

confidence: 99%

The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

Huang

Wang

Gong

et al. 2023

Journal of Oncology

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Facial Artery Perforator Flap for Perioral and Perinasal Oncologic Defect Reconstruction: Surgical Technique and Postoperative Outcomes

Chiche,

Avry,

Drouet

et al. 2024

Microsurgery

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IntroductionFacial artery perforator (FAP) flap is a versatile and reliable one‐step facial reconstruction technique. However, its full potential remains underutilized due to a lack of clear guidelines and rigorous technique requirements. This study report the use of FAP flaps in our centre for the management of perioral and nasal oncologic defects, focusing on surgical technique performed and post‐operative management.MethodsWe conducted a retrospective review of all patients who underwent reconstruction with a perioral or perinasal FAP flap only following tumor resection over a 4‐year period (n = 29). Parameters measured included flap survival, complication rates, surgical technique performed, and the need for touch‐up procedures. Patients were grouped based on age, defect size, and location and outcomes were compared across these groups.ResultsThe mean histological tumor defect area was 331 mm2. During at least 6 months of follow‐up, no local recurrence was observed. Twenty‐seven (93.1%) flaps survived completely. Major postsurgical complications occurred in seven (23.8%) patients, including complete flap necrosis (1), partial flap necrosis (1), flap collapse (1), venous congestion (1), wound dehiscence (1), and local infection (2). A higher complication rate was associated with nose tip defects (80.0% vs. 12.5%, p = 0.007). Touch‐up procedures were more frequently required for reconstructions involving the nasal sidewall and dorsum (53.8% vs. 13.3%, p = 0.04).ConclusionBased on our experience, the FAP flap is highly effective for the reconstruction of the upper lip, nasolabial fold, and certain oncologic nasal defects. However, specific defect locations, such as the nose tip, may be associated with higher complication rates, necessitating careful patient selection and surgical planning.

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Gestielte Gewebetransplantation

Ehrenfeld¹,

Cornelius²

2021

Mund-, Kiefer- Und Gesichtschirurgie

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The Facial Artery Perforator Flap as a New Option for Reconstruction of Intraoral Defects: Surgical Tips and Clinical Series

Cited by 7 publications

References 19 publications

The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

Facial Artery Perforator Flap for Perioral and Perinasal Oncologic Defect Reconstruction: Surgical Technique and Postoperative Outcomes

Gestielte Gewebetransplantation

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