Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou 646000, China.
Department of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou 646000, China; National Key Clinical Specialty, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Aug;134(2):143-150. doi: 10.1016/j.oooo.2021.12.130. Epub 2021 Dec 28.
To evaluate a novel method and computed tomography angiography (CTA) for locating anterolateral thigh flap (ALTF) perforators to design individualized ALTFs to reconstruct maxillofacial soft tissue defects.
This study comprised a group of 36 patients (CTA group) with malignant oral and maxillofacial tumors who underwent CTA and who received individualized ALTFs and a group of 28 patients (control group) with the same condition but without preoperative CTA examination and with nonindividualized ALTFs. ALTFs in the CTA group were designed and harvested using the locating device and CTA, whereas ALTFs in the control group were designed and harvested according to each surgeon's experience.
Fifty perforators were located and 36 ALTFs harvested in the CTA group. In the control group, 34 perforators were located and 28 ALTFs harvested. Less time was required to locate the perforators in the CTA group. Moreover, the CTA group had a higher flap survival rate and better patient satisfaction regarding the postoperative aesthetics and phonetic and swallowing functions.
The results suggest that CTA and the locating device can be used to accurately locate ALTF perforators and that this method aids in the design and harvesting of individualized ALTFs to achieve good functional and aesthetic outcomes.
评估一种新的方法和计算机断层血管造影（CTA）来定位股前外侧皮瓣（ALTF）穿支，以设计个体化的 ALTF 来重建颌面软组织缺损。
本研究包括一组 36 例（CTA 组）患有恶性口腔颌面部肿瘤的患者，他们接受了 CTA 检查，并接受了个体化的 ALTF 治疗，以及一组 28 例（对照组）具有相同情况但未接受术前 CTA 检查和非个体化的 ALTF 治疗的患者。CTA 组的 ALTF 是使用定位装置和 CTA 设计和采集的，而对照组的 ALTF 是根据每位外科医生的经验设计和采集的。
在 CTA 组中定位了 50 个穿支并采集了 36 个 ALTF，在对照组中定位了 34 个穿支并采集了 28 个 ALTF。在 CTA 组中，定位穿支所需的时间更短。此外，CTA 组的皮瓣存活率更高，患者对术后美学和语音、吞咽功能的满意度也更高。
结果表明，CTA 和定位装置可用于准确定位 ALTF 穿支，并且该方法有助于设计和采集个体化的 ALTF，以实现良好的功能和美学效果。
