Abstract：Objective To investigate the application and efficacy of individual designed anterolateral thigh perforator flap (ALTPF) by CT angiography(CTA) in head and neck surgery.MethodsA retrospective analysis of Sichuan Provincial Cancer Hospital Head and Neck Surgery ALTPF transplant repair from March 2012 to June 2014 lines of head and neck tumor radical resection 20 patients of head and neck cancer patients, which among 11 males and 9 females. The age ranged from 24 to 79 years, mean age was 51.42 year. 13 patients of tongue, floor of mouth cancer 2 patients, buccal cancer 3 patients, 2 patients of hypopharyngeal. All patients underwent primary tumor extended radical mastectomy and unilateral or bilateral neck dissection. The defects ranged from 6 cm ×5 cm to 10 cm × 7 cm. To design and locate the ALTPF by the findings of preoperative CTA and reconstruct the wound defect by the radical resection. And the donor sites were layered sutured directly. Observation whether the donor site anterolateral thigh perforator vessels was consistent with preoperative imaging positioning during surgery. The indexes of flap survival and wound healing were observed, and flap texture, donor site function and patients′ satisfaction in follow-up were evaluated.Results Surgery was successfully performed in 20 patients, and the consistent rate of intraoperative findings through branches with preoperative imaging localization was 100%. There were 12 patients of single free ALTPF, 3 patients of double flaps with one vascular pedicle, and 5 patients of compound muscle flaps. The flap size ranged from 6 cm×5 cm to 10 cm×7 cm, and the additional muscle flaps′ size ranged from 2 cm×3 cm to 3 cm×4 cm. The length of vascular pedicle ranged 7 cm to 10 cm [mean (8.0±2.23) cm]. Nineteen flaps were fully alive, the other one was partly alive. The reason of partial necrosis was local infection, and then the remaining part survived by dressing and trimming. In 20 patients donor site wounds, 19 patients were primary healing and 1 patient delayed healing for effusion in operation area. All patients were followed up from 6 to 30 months, average 13.6 months. Appearance and consistency of the flaps were satisfying. No case of thigh donor site occurred limb dysfunction. Eighteen cases of patients with tumor-free survival, local tumor recurrence in two patients, which reoperation repairing by pectoralis major flap.Conclusions Preoperative CTA can provide ALTPF precise anatomical information through vessel characteristics, different types of guidance anterolateral thigh perforator flap preoperative design individualized repair of head and neck defects.
陈锦,王朝晖,唐涛,周鹏,李春华,于涛. CT血管成像个体化设计股前外侧穿支皮瓣在头颈外科手术中的应用[J]. 中华解剖与临床杂志, 2016, 21(4): 337-341.
Chen Jin, Wang Zhaohui, Tang Tao, Zhou Peng, Li Chunhua, Yu Tao. The individualized design of anterolateral thigh perforator flap penetration with CT angiography in the application of head and neck surgery. Chinese Journal of Anatomy and Clinics, 2016, 21(4): 337-341.
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2016, Vol. 21 
