Osteomyocutaneous peroneal artery-based combined flap for reconstruction of composite and en bloc mandibular defects

Background The osteomyocutaneous peroneal artery‐based combined (OPAC) flap is a refinement of fibula osteoseptocutaneous flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator. Methods Seventeen men underwent composite oromandibular reconstruction using an...

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Bibliographic Details
Published in:Head & neck 2009-03, Vol.31 (3), p.361-370
Main Authors: Cheng, Ming-Huei, Saint-Cyr, Michel, Ali, Rozina S., Chang, Kai-Ping, Hao, Sheng-Po, Wei, Fu-Chan
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Carcinoma, Squamous Cell - surgery
composite mandibular defect
Fibula - transplantation
fibula osteoseptocutaneous flap
Follow-Up Studies
Graft Survival
Humans
Male
Mandible - surgery
mandibular reconstruction
Medical sciences
Middle Aged
Mouth Neoplasms - surgery
Muscle, Skeletal - transplantation
osteomyocutaneous
Otorhinolaryngology. Stomatology
peroneal artery-based combined flap
Reconstructive Surgical Procedures - methods
Speech
Surgical Flaps - blood supply
Tibial Arteries - transplantation
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Summary:Background The osteomyocutaneous peroneal artery‐based combined (OPAC) flap is a refinement of fibula osteoseptocutaneous flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator. Methods Seventeen men underwent composite oromandibular reconstruction using an OPAC flap. Flaps were raised with 1 or 2 skin paddles and 2 to 3 bone segments. In 8 cases, a portion of soleus muscle was included. Results All flaps survived, but partial failure occurred in 2 cases (11.7%). At a mean follow‐up of 25.3 ± 19.4 months, 6 of 12 patients tolerated a regular diet, 5 a soft diet, and 1 a liquid diet. Speech was normal in 2 patients, intelligible in 4, and slurred in 6. Conclusion Advantages of the OPAC flap include a single donor site, 1 pair of recipient vessels, versatile 3‐dimensional inset, adequate soft tissue augmentation, and better aesthetic and functional outcomes. © 2008 Wiley Periodicals, Inc. Head Neck, 2009
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.20969