China Journal of Oral and Maxillofacial Surgery ›› 2019, Vol. 17 ›› Issue (3): 275-279.doi: 10.19438/j.cjoms.2019.03.017

• Clinical Reports • Previous Articles     Next Articles

Application of posterior tibial artery flap in the reconstruction of oral and maxillofacial defects: Clinical analysis of 80 consecutive cases

MAI Lian-xi, Mubarak Mashrah, YAN Ling-jian, WAN Quan, LIN Zhao-yu, PAN Chao-bin   

  1. Department of Oral and Maxillofacial Surgery, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University. Guangzhou 510120, Guangdong Province, China
  • Received:2018-09-10 Revised:2018-12-10 Online:2019-05-20 Published:2019-06-21

Abstract: PURPOSE: To explore the efficacy and design of posterior tibial artery flaps (PTAF) in the reconstruction of oral and maxillofacial defects. METHODS: Between November 2017 and August 2018, 80 patients underwent reconstruction of oral and maxillofacial defects with posterior tibial artery flaps. All of them received preoperative examinations with computed tomography angiography (CTA) to identify the course and perforators of the posterior tibial artery. During surgery, the designed and dissected PTAF was transferred to the recipient site and filled the defects. Data including the thickness and the size of the flap, length and diameter of the artery, number and length of perforators, survival rate of the flaps, complications at both the donor and recipient sites were collected and analyzed. RESULTS: Of 80 patients, 56 were male and 24 were female, ranging in age from 24-90(58.17±1.43) years. The flaps measured from 5 cm×6 cm to 7 cm×13 cm, the thickness of the flap was 0.30-1.00(0.53±0.2) cm, the pedicle length of the PTAF was 8-14(10.03±1.4) cm. The caliber of the posterior tibial artery was 1.50-3.00(2.36±0.4) mm, the caliber of the posterior tibial vein was 1.50-4.0(2.99±0.6) mm. The number of the septocutaneous perforator was 1-5(2.61±0.9) per leg, mostly clustered in the middle and distal thirds of the middle surface of the leg. The length of the perforators was 0.3-6(1.70±0.7)cm. All PTAF survived well. Skin graft was required in all cases for donor site of PTAF. Total loss of the skin graft occurred in 2/80 (2.5%) of the patients. Partial loss of the skin graft occurred in 7/80 (8.7%) of the patients, but all healed by conservative treatment. CONCLUTIONS: It's an ideal choice to reconstruct oral and maxillofacial defect with PTAF. Also, caring the adipofascial extension is a better way to plump the form of the tongue, fill up the defect of the mouth floor and protect the vascular anastomosis from outer irritation.

Key words: Posterior tibial artery perforator flaps, Oral and maxillofacial defects, Tumor, Reconstruction

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