Department of Plastic and Reconstructive Surgery, Ulsan University, College of Medicine, Seoul Asan Medical Center, Seoul, Korea.
J Reconstr Microsurg. 2013 Sep;29(7):437-42. doi: 10.1055/s-0033-1343959. Epub 2013 Apr 24.
Oropharyngeal defects left after tumor resection are usually reconstructed with radial forearm or anterolateral thigh (ALT) perforator free flaps, but these flaps can be too thin or too thick. In this study, medial sural perforator free flaps with intermediate volumes were used for oropharyngeal reconstruction. Of the 243 patients with oropharyngeal cancer who underwent head and neck reconstruction between October 2006 and October 2011, the medial sural perforator free flap was used 20 times. The number and locations of the main sizable perforators, the dimensions and thickness of the flap, and the length of the pedicle were recorded. Satisfactory results were achieved in 18 patients. The flaps in the two remaining cases failed. The vertical locations of the main sizable medial sural perforators were 6 to 15 cm away from the popliteal crease. The medial sural perforator free flaps ranged from 4 to 10 mm in thickness. Medial sural perforator free flaps may be an alternative for medium-sized defects that cannot be properly reconstructed with radial forearm or ALT perforator free flaps because of their inappropriate flap volume.
口咽肿瘤切除术后留下的缺损通常采用游离前臂桡侧或股前外侧穿支皮瓣进行重建，但这些皮瓣可能过薄或过厚。本研究采用中等体积的腓肠内侧穿支皮瓣进行口咽重建。2006 年 10 月至 2011 年 10 月期间，243 例接受头颈部重建的口咽癌患者中，20 例采用腓肠内侧穿支皮瓣。记录了主要大口径穿支的数量和位置、皮瓣的尺寸和厚度以及蒂的长度。18 例患者获得满意效果。其余两例皮瓣失败。主要大口径腓肠内侧穿支的垂直位置距离腘窝褶皱 6 至 15 厘米。腓肠内侧穿支皮瓣厚度为 4 至 10 毫米。腓肠内侧穿支皮瓣可能是一种替代选择，适用于因皮瓣体积不合适而无法用游离前臂桡侧或股前外侧穿支皮瓣适当重建的中等大小缺损。
