The use of CTA combined augmented reality navigation in free anterolateral thigh perforator flap for tongue reconstruction: 9 cases report

Abstract

Objective To explore the value of CTA combined augmented reality(AR) navigation in tongue reconstruction with free anterolateral thigh perforator (ALTP) flaps. Methods From December, 2016 to December, 2018, 9 cases of tongue cancer patients were treated with lingual reconstruction with the free ALTP flap. The dominant perforator was selected according to CTA before operation. The origin, course, locations at the level passing through the fascia lata of the perforators and digital flaps were located and marked under the guidance of AR navigation technology. The flaps area were 6 cm×8 cm-8 cm×12 cm, and the donor sites were closed directly. The effect of the AR navigation was explored intraoperatively. The function of reconstructed tongue and donor site were followed-up 3 to 6 months post-operatively. Results All navigation-positioned perforators were confirmed by AR preoperatively. Intraoperative exploration showed that the perforators were accurately located. All flaps survived, and no vascular crisis occurred. The donor sites healed primarily with linear scars. The tongue was plump, and the function of voice and swallowing were favorable. Conclusion CTA combined AR navigation has the advantages of accurate location, easy to use and low cost in tongue reconstruction with free ALTP flaps. It is a worthy method to be popularized. Key words: Anterolateral thigh perforator flap; Tongue reconstruction; Augmented reality technology; CT angiography; Microsurgical technique