Use of free flaps with supermicrosurgery for oncological reconstruction of the maxillofacial region |
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| Affiliation: | 1. Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore, National University Centre for Oral Health, Singapore;2. Department of Orthodontics, National Dental Centre Singapore, Singapore;1. Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China;2. National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China;3. Key Laboratory of Oral Pathology, School and Hospital of Stomatology, Peking University, Haidian District, Beijing, PR China;1. Discipline of Oral and Maxillofacial Surgery, Second Xiangya Hospital, Central South University, Changsha, China;2. Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong, China;1. Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan;2. Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, Fukuoka, Japan;3. Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan;4. Laboratory of Oral Pathology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan;1. Department of Oral and Maxillofacial Surgery, A.B. Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangaluru, Karnataka, India;2. Kamineni Institute of Dental Sciences, Dr. NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India |
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| Abstract: | Supermicrosurgery involves the dissection and anastomosis of vessels<0.8 mm in diameter with minimal donor site morbidity. This study evaluated the feasibility and outcomes of free flaps using supermicrosurgery to repair oncological defects in the maxillofacial region. Forty-two patients were treated with supermicrosurgery to repair oncological defects in the maxillofacial region between December 2015 and February 2021. The supermicrosurgery technique was used for different types of free flap, including 24 superficial circumflex iliac artery perforator flaps, seven anterolateral thigh flaps, three peroneal artery perforator flaps, five medial femoral condyle osteo-adipofascial flaps, and three profunda artery perforator flaps. An artery-to-artery approach was used in 38 patients; venous grafts for anastomosis were used in four patients to resolve an arterial discrepancy. Forty-one flaps (97.6%) survived. Thirty-six patients (85.7%) healed without any complications; three flaps required revision surgery including one lost, one demonstrated wound dehiscence, and two demonstrated wound infection. Supermicrosurgery is a useful complement to conventional microsurgery in head and neck reconstruction. |
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| Keywords: | Head and neck neoplasms Perforator flap Mandibular reconstruction Microsurgery Reconstructive surgery |
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