China Journal of Oral and Maxillofacial Surgery ›› 2018, Vol. 16 ›› Issue (1): 78-83.doi: 10.19438/j.cjoms.2018.01.017

• Clinical Reports • Previous Articles     Next Articles

Reconstruction of oral and maxillofacial soft tissue defects with superficial inferior epigastric artery flap: report of 3 cases

WANG Hong-wei1, GUO Bing1, MA Chun-yue1, LI Xiao-guang1, YIN Jian-xin2, ZHOU Hui-hong2, AI Song-tao3, SUN Jian1, ZHANG Chen-ping1, QIN Xing-jun1   

  1. 1.Department of Oromaxillofacial Head and Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. Shanghai 200011;
    2. Department of Ultrasonic Diagnosis, 3.Department of Radiology, Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine. Shanghai 200011,China
  • Received:2017-07-27 Revised:2017-09-27 Online:2018-01-20 Published:2018-02-11

Abstract: PURPOSE: To investigate the clinical value of superficial inferior epigastric artery (SIEA) flap in oral and maxillofacial reconstruction. METHODS: Three patients underwent SIEA flap reconstruction. They had malignant tumors in oral cavity with soft tissue defects of the right tongue, left cheek and right mouth floor. All of them received preoperative examinations with color Doppler ultrasound and/or CT angiography to identify the course of SIEA and superficial inferior epigastric vein (SIEV). The planed size and shape of the SIEA flap was transduced to the inguinal region. SIEA and SIEV were dissected proximally and distally until a sufficient pedicle length was obtained. After vascular dissection, the pedicle was clipped. Then, the SIEA flap was transferred to the recipient site and sutured to the soft tissue defect. The reparative effects in recipient sites and complications at the donor sites were evaluated postoperatively. The patients were followed up for 12~14 months. RESULTS: The length of the flap was defined as the largest diameter in the pedicle direction and the width as the largest diameter at right angles to the flap axis. The effective size of the flaps was 9 cm×6 cm, 8cm×5 cm, and 10cm×6cm, respectively. The pedicle length of the SIEA flap was 8-10 cm, the caliber of the SIEA was 0.7-1.0mm. The caliber of the SIEV was 1.8-2.0 mm, the anastomoses between the SIEA and the superficial thyroid artery and the SIEV and one branch of the internal jugular vein were performed under operation microscope. The SIEA flap achieved reperfusion. In all 3 patients, the anastomoses were carried out without complications. Ideal outcome was obtained in the recipient sites. The SIEA flap also had no donor site problems. CONCLUSIONS: SIEA can be tracked by color Doppler and/or CT angiography. Its body surface projection line can also be marked. Therefore, the SIEA flap is easy to harvest. It has a good dimension and tissue quality and can easily be adapted to the soft tissue defect. In comparison with other flaps, it keeps the abdominal wall intact with the scar being hidden. Reconstruction of oral and maxillofacial defect with SIEA flap has several advantages including good functional outcome and low donor site morbidity.

Key words: Superficial inferior epigastric artery flap, SIEA, Oral and Maxillofacial region, Soft tissue defects

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