EARLY EFFECTIVENESS OF POSTERIOR RADIAL COLLATERAL ARTERY PERFORATOR COMPOUND FLAP FOR RECONSTRUCTION OF TONGUE DEFECTS AFTER TUMOR EXCISION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHEN Yong , YANG Xudong , LI Wei , HU Qingang.

Department of Oral and Maxillofacial Surgery, Institute and Hospital of Stomatology, Nanjing University Medical School, Nanjing Jiangsu, 210008, P.R.China. Corresponding author: CHEN Yong, E-mail: chenyongsurgeon@hotmail.com;

Corresponding author：

Keywords：

Posterior radial collateral artery; Extended lateral arm free flap; Triceps muscle flap; Tongue defect; Repair

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ObjectiveTo summary the application and effectiveness of the posterior radial collateral artery (PRCA) compound flap in reconstruction of soft tissue defect after tongue cancer excision. MethodsBetween August 2011 and October 2011, 5 patients with squamous cell carcinoma underwent tongue defects reconstruction with compound flap with extended lateral arm free flap (ELAFF) and triceps muscle flap (TMF) after ablation in one-stage. All patients were male with an average age of 59 years (range, 43-71 years). The disease duration was 25-60 days (mean, 42 days). After extended resection, 3 cases had 1/3 tongue and mouth floor defect, and 2 cases had 1/2 tongue and mouth floor defect. The size of ELAFF ranged from 7 cm × 5 cm to 9 cm × 5 cm, and the size of TMF ranged from 3 cm × 3 cm to 4 cm × 4 cm. The donor sites were directly sutured. ResultsAll compound flaps survived. The wounds at donor sites and recipient sites healed primarily. The patients were followed up 6 months. After operation, the tongue had good appearance and motion; the patients had clear voice and no dysphagia. No recurrence was observed during follow-up. Local numbness appeared at the donor sites, but the function of the elbows was normal. ConclusionThe application of the compound flap of ELAFF and TMF based on PRCA perforator is a better option to reconstruct tongue defects for its reliable blood supply, appropriate thickness, easy operative procedures, and less complication.

Citation： CHEN Yong,YANG Xudong,LI Wei,HU Qingang.. EARLY EFFECTIVENESS OF POSTERIOR RADIAL COLLATERAL ARTERY PERFORATOR COMPOUND FLAP FOR RECONSTRUCTION OF TONGUE DEFECTS AFTER TUMOR EXCISION. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(11): 1336-1339. doi: Copy

1.
2.	Calabrese L, Saito A, Navach V, et al. Tongue reconstruction with the gracilis myocutaneous free flap. Microsurgery, 2011, 31(5): 355-359.
3.	Kao HK, Chang KP, Chen YA, et al. Anatomical basis and versatile application of the free medial sural artery perforator flap for head and neck reconstruction. Plast Reconstr Surg, 2010, 125(4): 1135-1145.
4.	Haas F, Ensat F, Windhager R, et al. Reconstructive potential of the lateral arm flap after tumor resection. Microsurgery, 2007, 27(3): 166-173.
5.	Reinert S. The free revascularized lateral upper arm flap in maxillofacial reconstruction following ablative tumour surgery. J Craniomaxillofac Surg, 2000, 28(2): 69-73.
6.	Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
7.	Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
8.	Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
9.	Tan BK, Wong CH, Chew W, et al. Use of the slit arteriotomy for end-to-side arterial anastomosis in free-tissue transfers to the extremities. J Plast Reconstr Aesthet Surg, 2009, 62(11): 1519-1523.
10.	陈勇, 杨旭东, 李威, 等. 游离延展上臂外侧皮瓣修复洞穿性颊部缺损一例. 中国修复重建外科杂志, 2012, 26(4): 508-510.
11.	Marques Faria JC, Rodrigues ML, Scopel GP, et al. The versatility of the free lateral arm flap in head and neck soft tissue reconstruction: clinical experience of 210 cases. J Plast Reconstr Aesthet Surg, 2008, 61(2): 172-179.
12.	Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg, 1981, 67(2): 177-187.
13.	王斌, 李康华, 邵新中, 等. 游离肱三头肌外侧头肌皮瓣修复前臂软组织缺损. 中华手外科杂志, 2006, 22(3): 165-166.
14.	林浩东, 方有生, 陈德松. 肱三头肌外侧头移位重建伸腕功能. 中国矫形外科杂志, 2007, 15(1): 67-68.
15.	Koshima I. A new classification of free combined or connected tissue transfers: introduction to the concept of bridge, siamese, chimeric, mosaic, and chain-circle flaps. Acta Med Okayama, 2001, 55(6): 329-332.
16.	Hallock GG. Further clarification of the nomenclature for compound flaps. Plast Reconstr Surg, 2006, 117(7): 151e-160e.
17.	徐中飞, 代炜, 张恩礁, 等. 股前外侧穿支嵌合瓣修复头颈肿瘤根治术后缺损. 上海口腔医学, 2012, 21(1): 107-112.
18.	Liu WW, Yang AK, Ou YD. The harvesting and insetting of a chimeric anterolateral thigh flap to reconstruct through and through cheek defects. Int J Oral Maxillofac Surg, 2011, 40(12): 1421-1423.
19.	Kuo YR, Shih HS, Chen CC, et al. Free fibula osteocutaneous flap with soleus muscle as a chimeric flap for reconstructing mandibular segmental defect after oral cancer ablation. Ann Plast Surg, 2010, 64(6): 738-742.

1.
2. Calabrese L, Saito A, Navach V, et al. Tongue reconstruction with the gracilis myocutaneous free flap. Microsurgery, 2011, 31(5): 355-359.
3. Kao HK, Chang KP, Chen YA, et al. Anatomical basis and versatile application of the free medial sural artery perforator flap for head and neck reconstruction. Plast Reconstr Surg, 2010, 125(4): 1135-1145.
4. Haas F, Ensat F, Windhager R, et al. Reconstructive potential of the lateral arm flap after tumor resection. Microsurgery, 2007, 27(3): 166-173.
5. Reinert S. The free revascularized lateral upper arm flap in maxillofacial reconstruction following ablative tumour surgery. J Craniomaxillofac Surg, 2000, 28(2): 69-73.
6. Katsaros J, Schusterman M, Beppu M, et al. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg, 1984, 12(6): 489-500.
7. Brandt KE, Khouri RK. The lateral arm/proximal forearm flap. Plast Reconstr Surg, 1993, 92(6): 1137-1143.
8. Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg, 1991, 7(3): 167-173.
9. Tan BK, Wong CH, Chew W, et al. Use of the slit arteriotomy for end-to-side arterial anastomosis in free-tissue transfers to the extremities. J Plast Reconstr Aesthet Surg, 2009, 62(11): 1519-1523.
10. 陈勇, 杨旭东, 李威, 等. 游离延展上臂外侧皮瓣修复洞穿性颊部缺损一例. 中国修复重建外科杂志, 2012, 26(4): 508-510.
11. Marques Faria JC, Rodrigues ML, Scopel GP, et al. The versatility of the free lateral arm flap in head and neck soft tissue reconstruction: clinical experience of 210 cases. J Plast Reconstr Aesthet Surg, 2008, 61(2): 172-179.
12. Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg, 1981, 67(2): 177-187.
13. 王斌, 李康华, 邵新中, 等. 游离肱三头肌外侧头肌皮瓣修复前臂软组织缺损. 中华手外科杂志, 2006, 22(3): 165-166.
14. 林浩东, 方有生, 陈德松. 肱三头肌外侧头移位重建伸腕功能. 中国矫形外科杂志, 2007, 15(1): 67-68.
15. Koshima I. A new classification of free combined or connected tissue transfers: introduction to the concept of bridge, siamese, chimeric, mosaic, and chain-circle flaps. Acta Med Okayama, 2001, 55(6): 329-332.
16. Hallock GG. Further clarification of the nomenclature for compound flaps. Plast Reconstr Surg, 2006, 117(7): 151e-160e.
17. 徐中飞, 代炜, 张恩礁, 等. 股前外侧穿支嵌合瓣修复头颈肿瘤根治术后缺损. 上海口腔医学, 2012, 21(1): 107-112.
18. Liu WW, Yang AK, Ou YD. The harvesting and insetting of a chimeric anterolateral thigh flap to reconstruct through and through cheek defects. Int J Oral Maxillofac Surg, 2011, 40(12): 1421-1423.
19. Kuo YR, Shih HS, Chen CC, et al. Free fibula osteocutaneous flap with soleus muscle as a chimeric flap for reconstructing mandibular segmental defect after oral cancer ablation. Ann Plast Surg, 2010, 64(6): 738-742.

Chinese Journal of Reparative and Reconstructive Surgery

EARLY EFFECTIVENESS OF POSTERIOR RADIAL COLLATERAL ARTERY PERFORATOR COMPOUND FLAP FOR RECONSTRUCTION OF TONGUE DEFECTS AFTER TUMOR EXCISION

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