Anterolateral thigh flap for repairing oral and maxillofacial defects based on preoperative CT angiography

Abstract

Objective To investigate the clinical application value of anterolateral thigh flap based on computer tomography angiography (CTA) and three-dimensional reconstruction in repair of oral and maxillofacial defects. Methods Preoperative CTA examination was performed on 12 cases of patients with oral and maxillofacial defect which was going to be repaired by anterolateral thigh flap. Image segmentation and 3D reconstruction were preformed by IntelliSpace Portal Philips software to determine the size, distribution, and three-dimensional anatomic relationship of the lateral femoral artery with the peripheral tissues. Point and area of anterolateral thigh flap was signed on the donor skin according to the image. The distribution of descending and perforating branches of lateral circumflex femoral artery was checked in operation, and individual flap based on size and shape of defected area was transplanted to the recipient site to repair the defect. Results The origination, structure of descending and perforating branches of lateral circumflex femoral artery as well as the three-dimensional anatomic relationship with its peripheral tissues can be displayed well by the CTA. During operation, the position and structure of perforator flaps were consistent with the result of pre-operative examination, the vessel position of recipient site was consistent with the result of pre-operative examination. The patients were followed up for 6-24 months. Twelve flaps survived completely and the shape and function of recipient site was good. Conclusions CAT and three-dimensional reconstruction can display three-dimensional anatomic stracture of flap vessel and its branches, which is a guidence for cutting and transplanting flap. Key words: Oral and maxillofacial; Tissue defect; Angiography; Three-dimensional reconstruction; Anterolateral thigh flap