Department of Oral and Maxillofacial Surgery, Klinikum rechts der Isar, Technische Universität München, Germany.
J Craniomaxillofac Surg. 2012 Dec;40(8):e253-7. doi: 10.1016/j.jcms.2011.10.030. Epub 2011 Nov 25.
The soleus perforator flap is a soft tissue flap with minimal donor site morbidity however is not frequently utilised due to the unpredictability of the perforating vessel to serve as the vascular pedicle. We have trialed the use of CT-angiography as a planning tool to predict location, length, course, and calibre of the pedicle to make this a more reliable choice.
Twenty consecutive patients with intraoral squamous cell carcinomas were assessed with CT-angiography to examine the peroneal perforators before considering soleus flap raising. If a sizeable perforator could be visualised at the upper half of the lower leg, flap raising was carried out, and the result of the CT-angiography was compared with the intra-operative findings.
CT-angiography allowed for visualisation of perforators measuring 1mm in diameter and could predict location, length and course of the vessel. Accordingly, eight of the 20 patients had to be excluded from flap raising due to missing, too fine or too far distally located perforators. Intra-operative findings corresponded well with the results of the CT-scans.
CT-angiography is a useful tool for planning the soleus perforator flap and allows selection of the most suitable perforator making the use of this flap more reliable.
比目鱼肌穿支皮瓣是一种软组织皮瓣，供区并发症发生率低，但由于穿支血管作为血管蒂的不可预测性，其应用并不广泛。我们尝试使用 CT 血管造影作为一种规划工具来预测蒂的位置、长度、走行和口径，以使这种皮瓣更可靠。
连续 20 例口腔鳞癌患者在考虑比目鱼肌皮瓣转移前，通过 CT 血管造影检查腓动脉穿支。如果小腿上段可以看到一个可观的穿支，就进行皮瓣转移，并将 CT 血管造影的结果与术中发现进行比较。
CT 血管造影可以显示直径为 1mm 的穿支，可以预测血管的位置、长度和走行。因此，由于缺失、过细或过远的穿支，20 例患者中有 8 例被排除在皮瓣转移之外。术中发现与 CT 扫描结果相符。
CT 血管造影是规划比目鱼肌穿支皮瓣的有用工具，可以选择最合适的穿支，使这种皮瓣的应用更可靠。
