Repair of significant tongue defect after tongue cancer radical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assistance: A report of 13 cases

Abstract

Objective To report the clinical effect of repair of significant tongue defect after tongue cancer radical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assis-tance. Methods From January, 2012 to November, 2015, 13 cases were performed using anterolateral thigh perforator free flap in the repair of significant tongue defect after tongue cancer radical resection. Preoperation CT scan of the free flap donor site was done to obtain the three-dimensional images of arterial blood area by Digital Three-dimensional Re-construction CT Technique to determine the origin of the anterolateral thigh flaps, direction, classification, length, diam-eter and the position of pedicle perforator. According to the condition of the defect of the tongue, flap of area from 10 cm× 9 cm to 8 cm×6 cm was design, the flap arteries and veins were anastomosed with the external maxillary artery or the superior thyroid artery, anterior vein, internal jugular vein or external jugular vein respectively. The shape and recovery of function of the reconstructed tongue were observed regularly after operation. Results All the flaps in the 13 cases survived, in the postoperative 4 to 18 months followed up ,the appearance of the reconstructed tongue was close to the normal one, the patients were satisfied with the mastication and feeding function. Conclusion CTA three-dimensional re-construction technique assisted anterolateral thigh perforator free flap technique is useful in obtaining good clinical effect, and it is one of the most best methods for repairing significant tongue defect after tongue cancer radical resection. Key words: Tongue; Reconstruction; Anterolateral thigh perforator flap; CTA technique; Microsurgical operation