Maxillofacial Plastic and Reconstructive Surgery最新文献

{"title":"Nonessential amino acid is not nonessential in geriatric patients: implications for maxillofacial wound healing and bone repair.","authors":"Seong-Gon Kim","doi":"10.1186/s40902-025-00465-w","DOIUrl":"10.1186/s40902-025-00465-w","url":null,"abstract":"<p><strong>Background: </strong>Nonessential amino acids (NEAAs) are traditionally regarded as dispensable because they can be synthesized endogenously from glucose-derived intermediates. Emerging evidence, however, shows that the capacity for de novo NEAA biosynthesis declines in aged tissues, rendering several of these molecules conditionally essential during periods of stress such as surgery or fracture repair.</p><p><strong>Main body: </strong>In the cranio-maxillofacial arena - where bone and soft-tissue regeneration must occur in an environment already compromised by osteoporosis, multimorbidity, and restricted oral intake - insufficient NEAA supply may translate into delayed union, wound dehiscence, and heightened infection risk. This narrative review integrates biochemical, preclinical, and clinical data to map age-dependent changes in the serine/glycine, glutamine/glutamate, arginine/citrulline, cysteine/trans-sulfuration, and alanine cycles, examines their impact on osteogenesis and mucosal healing, and evaluates nutritional or pharmacological strategies to restore NEAA sufficiency. Particular attention is paid to serine-one-carbon metabolism, the intestinal-renal arginine axis, and redox-sensitive cysteine pathways, all of which are intimately linked to collagen deposition, osteoblast differentiation, and immune modulation.</p><p><strong>Conclusion: </strong>We conclude that proactive optimization of NEAA status - through targeted supplementation or metabolic activation - represents a low-risk, biologically rational adjunct to enhance postoperative outcomes in geriatric maxillofacial patients.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"12"},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel 3D-printed simulator for hands-on training in orthognathic surgery.","authors":"Lukas Benedikt Seifert, Christopher Groepper, Rosa Rohin, Daniel Thiem, Philipp Becker, Florian Markus Thieringer, Robert Alexander Sader","doi":"10.1186/s40902-025-00462-z","DOIUrl":"10.1186/s40902-025-00462-z","url":null,"abstract":"<p><strong>Background: </strong>Orthognathic surgery addresses skeletal dysgnathias, enhancing both function and aesthetics. Despite its benefits, potential complications underscore the need for well-trained surgeons. 3D-printed anatomical models, a product of additive manufacturing, aid surgical education, especially for young surgeons lacking on-the-job training. This study focuses on an economically designed 3D-printed simulator for orthognathic surgery training.</p><p><strong>Results: </strong>Evaluation from 31 participants of two orthognatic surgery workshops using the 3D-printed simulator highlighted positive assessments for realism (7.16 ± 2.03/10) and usefulness in training for specific procedures. While commended for simulating limited oral cavity movements and providing a realistic general simulation, soft tissue realism (4.51 ± 2.66/10) suggested room for improvement. Notably, the simulator demonstrated outstanding cost-efficiency (€ 181.55), with reusable components.</p><p><strong>Conclusions: </strong>The 3D-printed simulator offers a realistic, cost-effective tool for orthognathic surgery training, despite soft tissue realism limitations. The study anticipates further enhancements in 3D-printing technology to address these aspects and advance future iterations.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"11"},"PeriodicalIF":2.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of zygomaticus major muscle and lip-closing force in orthognathic surgery: retrospective study.","authors":"Riku Kohara, Karen Gomi, Young-Min Shin, Akinori Moroi, Kunio Yoshizawa, Koichiro Ueki","doi":"10.1186/s40902-025-00466-9","DOIUrl":"10.1186/s40902-025-00466-9","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the zygomaticus major muscle and lip-closing force before and after orthognathic surgery. Sixty female patients with jaw deformities who underwent orthognathic surgery were included. Lip-closing force and computed tomography (CT) assessments were conducted preoperatively and 1 year postoperatively. Lip pressure was measured using the Lip De Cum LDC-110R® (Cosmos Instruments Co., Ltd., Tokyo, Japan). CT images were reconstructed using ProPlan CMF (Materialize, Belgium), and zygomaticus major muscle width and CT values were analyzed. To the best of our knowledge, no previous studies have employed CT values to assess muscles in the oral and maxillofacial area.</p><p><strong>Results: </strong>In both class II and class III females, postoperative zygomaticus major muscle width was significantly higher than preoperative values. In class II females, postoperative zygomaticus major muscle CT values were also significantly higher than preoperative values. Simple linear regression analysis with age as the dependent variable revealed significant associations between pre- and postoperative zygomaticus major muscle widths in both groups. Additionally, simple linear regression analysis with CT values as the dependent variable demonstrated significant associations with postoperative lip-closing force in both class II and class III females.</p><p><strong>Conclusions: </strong>This study suggests that orthognathic surgery significantly modifies the zygomaticus major muscle morphology and function, impacting CT values.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"10"},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and laterality of concha bullosa in patients with different cranial skeletal types: a retrospective analysis among cases with concha bullosa.","authors":"Farhad Ghorbani, Ali Modaberi, Nasim Morshedian, Ali Gorgin, Maryam Paknahad","doi":"10.1186/s40902-025-00463-y","DOIUrl":"https://doi.org/10.1186/s40902-025-00463-y","url":null,"abstract":"<p><strong>Objective: </strong>Concha bullosa, a common anatomical variation characterized by air-filled cavities in the turbinate bones, can influence sinonasal function and surgical planning. This study aims to evaluate the distribution, laterality, and cranial skeletal type associations of concha bullosa (CB) among patients with confirmed CB findings on computed tomography (CT) scans.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 774 patients who underwent cranial and facial CT scans between March 2023 and March 2024. Patients were classified into mesocephalic, brachycephalic, and dolichocephalic groups based on the cephalic index. The distribution and laterality of concha bullosa were assessed using CT scans, and statistical analyses were performed using the Chi-square test, with a significance level set at P < 0.05.</p><p><strong>Results: </strong>Among CB-positive patients, left-sided concha bullosa was most common (49.48%), followed by right-sided (31.91%) and bilateral (18.6%) involvement. Mesocephalic individuals constituted the largest proportion of CB-positive cases (55.56%), followed by dolichocephalic (22.86%) and brachycephalic (21.57%) individuals. A significant gender difference was observed in the mesocephalic (P = 0.001) and brachycephalic (P = 0.013) groups, with males exhibiting a higher prevalence of right-sided and bilateral concha bullosa.</p><p><strong>Conclusion: </strong>Concha bullosa distribution varies significantly among cranial skeletal types among CB-positive patients, with mesocephalic individuals exhibiting the highest overall prevalence. Our findings underscore the influence of cranial morphology on the presentation of CB. This insight may enhance radiological evaluation and individualized surgical planning in CB-positive patients.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"9"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and strategies in dental care for patients with intellectual disabilities in Hungary.","authors":"Ilona Szmirnova, György Szmirnov, Emese Gellérd, Zsolt Németh, Márton Kivovics, György Szabó","doi":"10.1186/s40902-025-00460-1","DOIUrl":"10.1186/s40902-025-00460-1","url":null,"abstract":"<p><strong>Background: </strong>Providing adequate dental care and implementing preventive strategies for patients with intellectual disabilities (ID) pose significant challenges in Hungary, where approximately 100,000 individuals with ID require specialized dental care. This study aimed to objectively assess the dental and periodontal care needs of patients with ID in comparison to the general population and those with physical disabilities. Additionally, we developed and evaluated a program focusing on acute treatment and the prevention of dental diseases.</p><p><strong>Methods: </strong>A retrospective analysis was conducted over a 5-year period, involving the demographics and therapeutic outcomes of 1717 patients with ID who received dental care. Initial screening of dental status was performed for 350 patients with ID, and a structured preventive care program was developed and implemented for 49 patients.</p><p><strong>Results: </strong>Over the 5 years, 8147 dental interventions were performed under general anesthesia without major complications. Compared to the general population, patients with ID exhibited poorer Decayed and Missing scores but more favorable Filled scores based on the decayed, missing, and filled teeth (DMFT) index. The implementation of preventive measures led to significant improvements in periodontal health within 3-6 months.</p><p><strong>Conclusions: </strong>Despite the success of preventive measures, the overall therapeutic outcomes in patients with ID were suboptimal, with caries and periodontal diseases increasing with age and severity of disability. Structured oral hygiene programs are essential to improving the oral health of this vulnerable population.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"8"},"PeriodicalIF":2.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in nasal reconstruction for facial clefts Tessier 3 bilateral and Tessier 0: a staged surgical approach case report.","authors":"Arif Tri Prasetyo","doi":"10.1186/s40902-025-00461-0","DOIUrl":"10.1186/s40902-025-00461-0","url":null,"abstract":"<p><strong>Background: </strong>Craniofacial anomalies, particularly Tessier facial clefts, present significant surgical and functional challenges. Bilateral Tessier 3 and Tessier 0 clefts are extremely rare, often requiring complex reconstructive strategies. These clefts result in severe nasal deformities, including absent nasal septum, hypertelorism, and malpositioned alae nasi, affecting both appearance and function. Due to the lack of standardized approaches in such cases, this report highlights a staged surgical reconstruction aimed at restoring nasal structure and improving facial harmony, with a 12-month follow-up showing stable nasal contour and functional airway restoration.</p><p><strong>Case presentation: </strong>A 16-year-old female presented with bilateral Tessier 3 and Tessier 0 clefts, exhibiting hypertelorism, a wide nasal dorsum, cranial displacement of the alae nasi, and an absent nasal septum. The patient underwent staged reconstruction. The first stage repositioned the alae nasi and created a functional nasal airway. In the second stage, costal cartilage was used to construct an L-shaped septal extension graft and dorsal onlay graft to restore nasal contour and stability. A subsequent procedure refined the nasal dorsum and approximated the alae nasi. Although orbital box osteotomy was planned to correct hypertelorism, the patient declined further intervention.</p><p><strong>Conclusion: </strong>This case highlights the effectiveness of a staged reconstructive approach in addressing rare craniofacial anomalies. Twelve-month postoperative follow-up confirmed the stability of nasal contour, functional airway patency, and satisfactory facial symmetry. The decision to forgo orbital box osteotomy emphasizes the role of patient-centered care in craniofacial surgery. This case provides valuable insights for optimizing reconstructive techniques in complex facial clefts.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"7"},"PeriodicalIF":2.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The three-dimensional finite element model of unilateral complete cleft lip and palate and mechanical analysis of the oral surfaces.","authors":"Qingqian Wei, Hao Liang, Jingyi Wang, Fei Chen, Yinyue Chen, Yiwei Liu, Haidong Li","doi":"10.1186/s40902-024-00452-7","DOIUrl":"10.1186/s40902-024-00452-7","url":null,"abstract":"<p><strong>Background: </strong>Cleft palate is a prevalent oral and maxillofacial malformation that requires complex surgical interventions. In cleft palate repair, managing flap tension is critical to avoid complications such as flap rupture and impaired healing. Additionally, excessive flap movement can compromise blood supply, affecting postoperative outcomes. A thorough understanding of these biomechanical factors is crucial for surgical success.</p><p><strong>Methods: </strong>A three-dimensional finite element model was developed using CT scan data to simulate the biomechanical behavior of the cleft palate under surgical conditions. The model was constructed and analyzed using ANSYS Workbench and related software, incorporating material properties of bone, mucosa, and muscle. Stress and deformation distributions were calculated to evaluate surgical incision points and flap movement.</p><p><strong>Results: </strong>The model identified critical areas of high tension and movement along the surgical incisions on both oral and nasal surfaces. The maximum deformation observed was 3.9885 mm, with stress concentration points along the suture lines and flap edges. The results highlighted specific regions prone to mechanical stress, which are crucial for optimizing surgical strategies.</p><p><strong>Conclusion: </strong>This study demonstrates the potential of a 3D finite element model in predicting mechanical responses of the cleft palate during surgical repair. The findings provide surgeons with valuable insights for improving incision placement, flap design, and suturing techniques to minimize tension and enhance healing. This personalized approach could significantly improve surgical outcomes and reduce postoperative complications in cleft palate repair.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"6"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of masticatory behavior of patients with mandibular prognathism.","authors":"Shumpei Mimura, Kanako Kurihara-Okawa, Naoya Fukamachi, Tsukasa Nagasaki, Kazuhiro Hori, Jumpei Okawa, Masaki Takeyama, Takahiro Ono, Isao Saito","doi":"10.1186/s40902-025-00458-9","DOIUrl":"10.1186/s40902-025-00458-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with mandibular prognathism exhibit not only its characteristic maxillofacial morphology but also discrepancies in stomatognathic function, and understanding this morphology and function is vital for establishing a plan for surgical orthodontic treatment or providing guidance for recovery after orthognathic surgery. However, few studies have yet addressed the objective evaluation of masticatory function before and after surgical orthodontic treatment. In particular, the masticatory behaviors that show how you chew in your daily meals, including the number of chews, chewing rate, and posture during chewing, has not yet been fully studied in patients with mandibular prognathism. The aim of this study was to compare the masticatory behaviors of patients with mandibular prognathism with that of patients with individualized normal occlusion, to clarify the characteristics of masticatory behaviors in mandibular prognathism and to search for a relationship with maxillofacial morphology.</p><p><strong>Methods: </strong>Participants were 23 patients (12 men, 11 women; mean age 17.9 years) with mandibular prognathism (patient group) and 23 patients (12 men, 11 women; mean age 24.4 years) with normal occlusion that had been achieved by orthodontic treatment (control group). Masticatory behaviors were measured by a wearable device fitted to each participant's right ear. Parameters such as number of chews, chewing rate, number of chews per bite, mealtime, and head and neck posture were recorded, while participants consumed a 100-g rice ball. Body mass index, occlusal contact area, and lateral cephalograms were also measured, and their associations with masticatory behaviors were investigated.</p><p><strong>Results: </strong>In patient group, the number of chews was lower, mealtime was shorter, and the head and neck were tilted further forward. There was a significant positive correlation between overjet and anteroposterior head and neck posture and a significant negative correlation between overbite and anteroposterior head and neck posture.</p><p><strong>Conclusion: </strong>Due to morpho/functional discrepancies in the stomatognathic system, patient group chewed fewer times and for a shorter time and leaned further forward while chewing. The characteristics of the masticatory behaviors of patients with mandibular prognathism identified in the present study may be helpful when devising plans for changing behavior before and after orthodontic treatment or orthognathic surgery.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"5"},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Tri-Lift suspension technique: a modified deep-plane lip lift for enhanced aesthetic outcomes-my personal approach.","authors":"Bayad Jaza Mahmood","doi":"10.1186/s40902-025-00459-8","DOIUrl":"10.1186/s40902-025-00459-8","url":null,"abstract":"<p><strong>Background: </strong>The subnasal lip lift has emerged as a popular intervention for correcting an elongated upper lip, although postoperative scarring remains a topic of concern. Various techniques have been discussed in the literature, with the Tri-Lift suspension technique highlighted in this study offering to reduce such complications and to assess the impact of modification in the deep plane subnasal lip lift, which includes triple suspension sutures, on nasal and labial aesthetic parameters.</p><p><strong>Results: </strong>A total of 193 female patients (mean age: 28 years) underwent the Tri-Lift suspension technique, while 50 female patients (mean age: 32.48 years) underwent the traditional lip lift (bullhorn technique). In the Tri-Lift group, 78.7% reported \"very much improvement,\" 20.2% \"much improvement,\" and 1% \"no change,\" compared to 43% \"very much improvement,\" 28.6% \"much improvement,\" 21.4% \"improved,\" and 7% \"no change\" in the traditional lip lift group. Quantitative measurements of philtral length, vermilion height, and dental show recorded preoperatively and 6 months postoperatively showed significant improvements in both groups. However, the Tri-Lift suspension technique achieved higher satisfaction rates, fewer adverse outcomes, and statistically significant differences in satisfaction levels (P < 0.05) compared with the traditional lip lift.</p><p><strong>Conclusions: </strong>The Tri-Lift suspension technique offers a solution to the common issue of scarring in subnasal lip lifts, enhancing both nasal and lip aesthetics. It presents a promising alternative to the traditional method, providing higher patient satisfaction and better aesthetic outcomes with reduced scarring.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"3"},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial sural artery perforator free flap for small- to medium-sized defects in head and neck reconstruction: a suitable replacement for radial forearm free flap.","authors":"Yulian Zhang, Keran Pan, Jian Wu, Xi Tang","doi":"10.1186/s40902-024-00455-4","DOIUrl":"10.1186/s40902-024-00455-4","url":null,"abstract":"<p><strong>Background and objectives: </strong>To compare clinical outcomes and donor site morbidity between medial sural artery perforator (MSAP) flap and radial forearm free (RFF) flap for soft tissue reconstruction of head and neck.</p><p><strong>Methods: </strong>Forty-six patients who underwent free flap reconstruction at the head and neck cancer center from February 2019 to March 2021 were included, of which 25 RFF flaps and 21 MSAP flaps. The patient and flap characteristics (age, sex, flap size, harvest time, etc.) and outcomes (success rate, donor site complications including infection, hematoma, and fistula, donor site morbidity including abnormal sensation, weakness, range of motion, postoperative oral function) were recorded and compared. Patients were followed up for at least 12 months after surgery. The patients were assessed subjective donor-site morbidity and satisfaction with overall functional results using a self-reported questionnaire.</p><p><strong>Results: </strong>The success rates of RFF flaps and MSAP flaps were 96% and 95.2%. There were no significant differences in age, sex, flap size, pedicle length, postoperative treatment, and postoperative oral function. MSAP flap showed less donor site morbidity and better subjective satisfaction at the donor site than RFF flap did after a 12-month follow-up. A dominant perforator of the medial sural artery emerges constantly near the point which is approximately 15 cm from the popliteal fossa center vertically, and 3 cm from the postor midline of the leg horizontally.</p><p><strong>Conclusion: </strong>Due to less donor site morbidity and higher patient satisfaction, MSAP flap can be used as a replacement for RFF flap for small to medium-sized defects in head and neck reconstruction.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"4"},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}