Fibular free flap with proximal perforator skin paddle due to aberrant anatomy - a case report.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Kyu-Bum Kim, Jihye Ryu, Jae-Yeol Lee
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引用次数: 0

Abstract

Background: The fibular free flap is considered one of the most valuable options for mandible reconstruction. A perforator flap has gained widespread acceptance in oral and maxillofacial reconstruction. Typically, the fibula flap is obtained primarily with the distal perforator due to its reliable blood supply, with less attention given to the proximal perforators during the harvesting process. Normally, the distal perforator of the fibula exhibits stability and shows limited anatomical variations. However, there have been reported cases in which the distal perforator is absent. At times, these vascular abnormalities remain undetectable through Doppler examination or preoperative angiography evaluation. Therefore, this case details the experience of encountering the rare event of vascular abnormality in oral cancer surgery.

Case presentation: This article reports the case of a patient who presented with a congenital absence of the distal perforator in the peroneal artery, attributed to a vascular abnormality. Additionally, we provide a review of the concept of utilizing the proximal perforator as an alternative approach in the flap harvesting process.

Conclusions: While the distal perforator of the peroneal artery is typically utilized for fibula free flap procedures, surgeons must remain cognizant of the potential for its absence due to aberrant anatomy. Recognizing an alternative approach in such cases can be pivotal for precise surgical planning and favorable outcomes in oral and maxillofacial reconstruction.

腓骨游离皮瓣与近端穿孔器皮瓣因解剖结构异常而导致的畸形--病例报告。
背景:腓骨游离皮瓣被认为是下颌骨重建最有价值的选择之一。穿孔皮瓣在口腔颌面重建中已被广泛接受。通常情况下,由于腓骨远端穿孔器具有可靠的血液供应,因此主要通过其获取腓骨皮瓣,而在采集过程中较少关注近端穿孔器。通常情况下,腓骨远端穿孔器表现稳定,解剖变化有限。不过,也有报道称腓骨远端穿孔器缺失的病例。有时,通过多普勒检查或术前血管造影评估仍无法发现这些血管异常。因此,本病例详细介绍了在口腔癌手术中遇到血管异常这一罕见情况的经验:本文报告了一例因血管异常导致腓动脉远端穿孔器先天性缺失的患者。此外,我们还回顾了在皮瓣采集过程中利用近端穿孔器作为替代方法的概念:结论:虽然腓动脉远端穿孔器通常用于腓骨游离皮瓣手术,但外科医生必须认识到由于解剖结构异常而导致穿孔器缺失的可能性。在这种情况下,认识到替代方法对于精确的手术规划和口腔颌面重建的良好效果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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