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Local and Regional Flaps of the Head and Neck, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Local and Regional Flaps of the Head and Neck, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Din Lam

(2014)

Additional Information

Book Details

Abstract

Editors Din Lam and Robert Strauss review important areas in Local and Regional Flaps of the Head and Neck. Articles will include: Basic flap design, Palatal island flap, Tongue flap, Facial artery musculomucosal flap /Nasolabial flap, Lip reconstruction, Temporalis system, Submental island flap, Platysmal flap, Cervicofacial flap, Paramedian flap, Supraclavicular/Trapezius system, Pectoralis flap, Latissiums Dorsi flaps, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Local and Regional Flaps of the Head and Neck\r i
Copyright\r ii
Contributors\r iii
Contents\r vii
Oral And Maxillofacial Surgery Clinics Of North America\r x
Preface\r xi
Basic Flap Design 277
Key points 277
History 277
Physiologic characteristics of skin 277
Preoperative considerations 278
Flap nomenclature 279
Local flaps 280
Advancement Flaps 280
Rotation Flaps 285
Transposition Flaps 289
Interpolated Flaps 296
Complications 301
Summary 303
References 303
Palatal Flap 305
Key points 305
Introduction 305
Anatomy 305
Indications and contraindications 306
Technique 306
Modifications 307
Random rotation-advancement flap 307
Submucosal modification 308
Palatal flap for skull-based defects 308
Complications 310
Discussion 310
References 310
Tongue Flaps 313
Key points 313
Introduction and history 313
Applied surgical anatomy 314
Indications, contraindications, alternatives 315
Indications 315
Contraindications 316
Alternatives 317
Anesthetic implications of tongue flap surgery 317
Surgical procedures 318
Dorsal Tongue Flap 318
Ventral Tongue Flap 319
Double- and Single-Door Tongue Flaps 320
Lateral Tongue Flap 321
Sliding and Island Tongue Flaps 321
Median Transit Tongue Flap 322
Complications 322
Summary 323
References 323
Maxillofacial Reconstruction with Nasolabial and Facial Artery Musculomucosal Flaps 327
Key points 327
Introduction 327
Nasolabial flap 327
Indications and Contraindications 328
Surgical Procedure 328
Preoperative planning and preparation 328
Inferiorly based flap 329
Surgical Procedure 329
Complications 330
Current Controversies/Future Considerations 330
The FAMM flap 330
Indications/Contraindications 330
Surgical Procedure 330
Preoperative planning 330
Preparation 330
Inferiorly based flap 331
Superiorly based flap 332
Complications 332
Current Controversies 332
Summary 332
References 332
Lip Reconstruction 335
Key points 335
Introduction 335
History 335
Anatomic considerations 336
Pathology and epidemiology 337
General considerations 338
Functional and esthetic considerations 338
Reconstructive strategies of upper and lower lips 339
Vermilion Defects 339
Healing by secondary intention 339
Primary closure 339
Mucosal V-Y advancement 340
Mucosal advancement flap 340
Mucosal cross lip flap 341
Partial-Thickness Defect 342
Primary closure 342
Island advancement flap 343
Full-Thickness Defect 344
Small full-thickness defects: primary closure 344
Medium full-thickness defects of lip 346
(I.A) Abbe flap 347
(I.B) Estlander 348
(I.C) 348
(II.A) Bilateral lip advancement 348
(II.B) Stair step design 349
(II.C) Gillies fan flap 349
(II.D) McGregor flap 351
(II.E) Karapandzic flap 351
Large full-thickness defect 352
Bilateral cheek advancement flaps (Bernard–von Burow) 352
Webster technique 352
Distant flap 352
Microvascular reconstruction 352
Commissuroplasty 353
Summary 354
References 354
The Temporalis Muscle Flap and Temporoparietal Fascial Flap 359
Key points 359
Introduction 359
Anatomy 359
Indications/Contraindications 360
Preoperative assessment 361
Temporalis muscle flap technique 361
Oral Reconstruction 361
Facial Reanimation Surgery 363
Midfacial Augmentation 363
Composite Flap 364
Complications 364
Flap Necrosis 365
Temporal Hollowing 365
Facial Nerve Injury 365
Restricted Mouth Opening 365
Temporoparietal fascial flap technique 365
Auricular Reconstruction 366
Orbitomaxillary Reconstruction 366
Oral Cavity Reconstruction 366
Additional considerations 367
Extending Pedicle Length 367
Composite Flap 367
Endoscopically Assisted Flap Harvesting 367
Complications 367
Flap Necrosis 367
Alopecia 368
Post-operative management 368
Summary 368
References 368
Submental Island Flap 371
Key points 371
Introduction 371
Flap specifications 371
Anatomy 372
Uses of the submental island flap 372
Contraindications 372
Preoperative considerations 373
Procedure 373
Patient Preparation and Positioning 373
Surgical Technique 373
Step 1: identify the location of perforator vessels using a Doppler 373
Step 2: plan the skin flap 373
Step 3: make inferior incision and elevate subplatysmal skin flaps to expose up to the digastric tendon 374
Step 4: identify vascular pedicle in submandibular triangle 375
Step 5: make superior incision and identify the facial vessels and marginal mandibular nerve 375
Step 6: begin elevating the skin paddle from distal to proximal 375
Step 7: divide the attachments of the anterior belly of the digastric muscle 375
Step 8: complete elevation of the flap from distal 375
Step 9: create a tunnel 376
Step 10: closure 376
Step 11: tracheostomy, if indicated 376
Variations in technique 377
Reverse Flow Venous Drainage via the External Jugular Vein 377
Retrograde Flow Artery and Reverse Flow Venous Drainage 377
Hybrid Flap 377
Free Flap 377
Postoperative care 377
Complications 378
Future considerations 378
Summary 378
References 378
The Platysma Myocutaneous Flap 381
Key points 381
Anatomy 382
Posteriorly based platysma flap 383
Surgical technique for the posteriorly based flap 384
Superiorly based platysma flap 384
Surgical technique 384
Discussion 385
Surgical principles to follow during flap development 386
References 386
The Use of Cervicofacial Flap in Maxillofacial Reconstruction 389
Key points 389
Introduction 389
Indications 390
Contraindications 390
Anatomy 391
The Cheek 391
SMAS 391
Flap Anatomy 391
Arterial supply 391
Venous drainage 391
Innervation 391
Preoperative planning 392
Patient Evaluation 392
Local 392
Systemic 392
Procedure 392
Preparation and Positioning 392
Technique 392
Incision and design 392
Dissection 393
Closure 394
Modifications 394
Increased Arc of Rotation 394
Dissection in the Facial Portion of the Flap: Subcutaneous Versus Sub-SMAS 394
Reverse CF Flap 394
Technique for Temporofrontal Defects 395
Orbital Exenteration 396
Postoperative care 396
Complications 396
Discussion 398
References 399
Paramedian Forehead Flap 401
Key points 401
Introduction 401
Indications/Contraindications 402
Technique/Procedure 402
Preoperative Planning 402
Anatomic Considerations 403
Surgical procedure 404
Surgical Armamentarium 404
Preoperative Preparation 404
Recipient Site Preparation 405
Flap Harvesting 405
Flap Insertion 405
Closing 405
Second Stage Procedure 406
Postoperative care 406
Additional considerations 407
Possible complications and management 407
Clinical results in the literature 408
Summary 409
References 409
The Supraclavicular Artery Island and Trapezius Myocutaneous Flaps in Head and Neck Reconstruction 411
Key points 411
Supraclavicular artery island flap 412
History 412
Anatomy 412
Indications 412
Imaging 412
Technique 413
Case Example 414
Pectoralis Major Myocutaneous Flap 421
Key points 421
Introduction 421
Preoperative considerations 422
Treatment Sequence 422
Arc of Rotation of the Flap 422
Potential Contraindications 422
Surgical anatomy 422
Surgical technique of the PMMC flap 423
Discussion 425
Summary 426
References 426
The Pedicled Latissimus Dorsi Myocutaneous Flap in Head and Neck Reconstruction 427
Key points 427
Introduction 427
Preoperative considerations 427
Regional anatomy 428
Neurovascular anatomy 429
Surgical development of the pedicled latissimus dorsi myocutaneous flap 429
Patient Positioning 429
Flap Design 429
Surface anatomy 429
Arc of rotation of the flap 430
Surgical procedure 430
Initial Incision 430
Pedicle Identification 430
Skin Paddle Development 431
Muscular Incision 431
Axillary Dissection 431
Mobilization 431
Tunneling 432
Interpectoral tunnel 432
Subcutaneous tunnel 432
Postoperative management 432
Complications 433
Intraoperative Complications 433
Postoperative Complications 433
Donor site 433
Flap success rate 433
Summary 434
References 434
Index 435