Pad Flap Research Articles

Granular cell ameloblastoma in maxilla: update of unusual clinical, radiographic and histological appearance

Objective: to describe the successful treatment of a 5mm-sized granular cell ameloblastoma in the posterior region of the maxilla, discovered in a routine examination during the evaluation of an oroantral communication. Patients and methods: the case repot is presented based on a simple literature review of the last 10 years with the descriptors (Ameloblastoma; Maxilla; Surgery; Oral Diagnosis; Neoplasms) in Pubmed. Treatment consisting of fistulectomy and closure of the oroantral communication with the buccal fat pad and vestibular flap was associated with enucleation and curettage of the adjacent lesion under local anesthesia. Results: a satisfactory evolution was observed in the 1 year postoperative, with a good healing aspect and no signs of oroantral complications or recurrence of the lesion. Conclusion: for minor lesions, more conservative treatment proposals such as enucleation represent a viable alternative and, in addition, the use of adjuvant techniques such as curettage can offer benefits when the differential diagnosis includes more aggressive lesions or with a higher rate of recurrence.

Closure of oronasal fistula by palatal rotational flap: case report with two years follow-up

Background/Aim: Hard palate fistulas are due to pathologies such as noma, syphilitic gom, leprosy, leishmaniasis, radiotherapy, removal of cysts or tumors of the sinus or palate, trauma or tooth attraction. Symptoms of palatal fistulas include hypernasality in the phonation due to nasal air escape during a speech, nasal cavity fluid flow, and infection due to food accumulation. Surgical repair of palatal perforations is technically difficult and complicated. Different surgical methods can be used depending on the size and location of the defect. Among these techniques, the locoregional flap types used are palatal flap, nasolabial flap, a buccal fat pad and tongue flap. Case Report: In this case report, we presented a patient with oronasal fistula due to a previous surgical operation, which was surgically closed by a palatal rotational flap. Conclusions: As a result, the oronasal communucation was relieved by successful closure of the defect and the donor area healed uneventfully.

Reliability of layered closure of oroantral fistula by using buccal fat pad and buccal advancement flap

Reliability of layered closure of oroantral fistula by using buccal fat pad and buccal advancement flap

Combining eyebrow and inferior palpebral margin incision for the facial rejuvenation in the upper eyelid and midface region

To investigate a simple, minimally invasive and effective operative method for the facial rejuvenation in the upper eyelid and midface region. Blepharoplasty was combined with suspending orbicularis oculi muscle flap and fixing it on the periosteum underneath the eyebrow through eyebrow incision. Meanwhile, for midface rejuvenation, inferior palpebral margin incision was performed and prezygomatic interspace was separated completely under the orbicularis oculi muscle. The under-eye puffiness and tear trough deformity were corrected through releasing orbital fat, reposition and fastening orbital septum, and transposition of orbicularis oculi muscle flap. And the deep sulci nasolabialis and cheek anetoderma were relieved by dual lifting of malar fat pad and orbicularis oculi muscle flap. Follow-up was taken at the 1 week,3 months,6 months,1 year,2years and 3 years after operation. Each case was evaluated with postoperative effect, reprocessing time and postoperative complications and underwent photography. From Feb.2010 to Oct.2014,190 patients (9 male,181 female, an average age of 49.03 ± 5.67 years) underwent this operation. Obvious improvement on the upper eyelid and midface region was achieved in all the patients after operation without serious or irreversible complication Combining eyebrow and inferior palpebral margin incision, through suspending the malar fat pad and orbicularis oculi muscle flap at the same time, as a simple, minimally invasive and reliable method, can strengthen the effect of the facial rejuvenation in the upper eyelid and midface region markedly.

One stage combined endoscopic and per-oral buccal fat pad approach for large oro-antral-fistula closure with secondary chronic maxillary sinusitis.

There are numerous surgical approaches for oro-antral-fistula (OAF) closure. Secondary sinus disease is still considered by many experts a relative contra indication for primary closure. To describe a single-stage combined endoscopic sinus surgery and per-oral buccal fat pad (BFP) flap approach for large OAF causing chronic maxillary sinusitis. The records of all the patients with OAF and chronic manifestations of secondary rhinosinusitis that were treated between 2010 and 2013 in our tertiary care medical center were reviewed. The exclusion criteria were: OAF ≤ 5 mm, resolved sino-nasal disease, OAF secondary to malignancy, recurrent fistula, medical history that included radiotherapy to the maxillary bone and age <18 years. Each procedure was performed by a team consisting of a rhinologist and a maxillofacial surgeon. The surgical approach included an endoscopic middle antrostomy with maxillary sinus drainage, and a per-oral BFP regional flap for OAF closure. Total OAF closure, complications and need for revision surgeries. Forty-five patients that underwent OAF closure together with sinus surgery using a combined endoscopic sinus surgery (ESS) and BFP flap approach met the inclusion criteria. There were 28 males and 17 females with a mean ± SD age of 53.5 ± 14.9 years (range 22-80 years). The presenting signs and symptoms included purulent rhinorrhea (n = 22, 48.9 %), foreign body in sinus (n = 10, 22.2 %) nasal congestion (n = 7, 15.5 %), halitosis (n = 6, 13.3 %) and pain (n = 5, 12.2 %). Surgical complications included local pain (n = 2, 4.4 %), persistent rhinitis (n = 2, 4.4 %) and synechia (n = 1, 2.2 %). One patient required revision surgery due to an unresolved OAF. The OAF of all the other 44 patients (97.8 %) was closed after the first procedure and the paranasal sinuses on the treated side were completely recovered. The mean follow-up time for the group was 7.6 ± 4.3 months (7-21 months), and no untoward sequelae or recurrence were reported. Combined, one step, endoscopic Maxillary sinus drainage together with per-oral BFP flap approach is an efficacious surgical approach for safe closure of OAFs that are complicated with secondary chronic maxillary sinusitis.

The Buccal Flap Pad Vascularized Rotational Flap for Reconstruction of Ventral Skull Base Defects

The Buccal Flap Pad Vascularized Rotational Flap for Reconstruction of Ventral Skull Base Defects

Free Dermal Fat Graft for Restoration of Soft Tissue Defects in Maxillofacial Surgery

Various local flaps have been used for reconstruction of developmental and post surgical soft tissue defects of maxillofacial region. They include nasolabial flap, palatal pedicled flap, buccal fat pad, temporalis muscle and fascia flap. An ideal flap for all indications is yet to be found. Our experience with free dermal fat graft in the correction of deformities associated with Parry Romberg syndrome and oral submucous fibrosis is presented.

The Microvascular Carpal Foot Pad Flap: Results in Three Clinical Cases

SummaryFour microvascular carpal foot pad transfers were performed on three dogs for reconstruction of weight bearing surfaces. All of the dogs had suffered severe trauma to the major weight bearing foot pads of at least one foot due to: burn injury (one dog), ischaemic injury (one dog) or sharp trauma (one dog). The vascular anatomy of the carpal foot pad flap was consistent in all of the dogs. The arterial pedicle arose from the caudal interosseous artery and the venous effluent drained via the cephalic vein. All of the flaps survived transfer. Post-operative care included heavily padded bandages and daily visual assessment of flap viability. All of the flaps developed partial wound dehiscence along their distal borders, presumably due to incisional stresses from weight bearing. The flaps were surgically repositioned as necessary in order to maintain a central weight bearing position. Ultimately, all of the flaps healed and hypertrophied to accomodate weight bearing stresses. In all dogs functional results were good.Foot pads are highly specialized to withstand the hostile environments into which they are placed. Reconstruction of weight bearing surface following loss of foot pads, therefore, is difficult. Microvascular free transfer of foot pads allows the reconstruction of such deficits with tissue that is, anatomically, most appropriately suited to adopt the function of weight bearing. Microvascular free transfer of the carpal foot pad flap for foot reconstruction is demonstrated in three clinical cases.

The Microvascular Carpal Foot Pad Flap: Vascular Anatomy and Surgical Technique

SummaryThe objectives of the study are to describe the vascular anatomy of the carpal foot pad and to describe the surgical technique for its dissection as a free microvascular flap.Sixteen front legs from ten different dogs weighing from 20 to 30 kg were used for the study. All of the dogs were euthanatized for reason unrelated to the study. Dissection of the carpal foot pad with its dominant arterial and venous pedicle was performed and angiographic studies were performed by injection of barium sulphate and “high detailed” radiography.The vascular anatomy of the carpal foot pad was consistent in all of the dogs. The arterial pedicle arises from the caudal interosseous artery and venous drainage is provided by the cephalic vein. A branch of the ulnar nerve parallels the arterial blood supply and may be included in flap dissection. Surgical dissection of the carpal foot pad flap is relatively straight forward. The length and diameter of the arterial and venous pedicle are appropriate for microvascular anastomosis.The carpal foot pad in the dog represents a viable option for microvascular transfer and reconstruction of weight bearing surfaces.Cadaveric dissection was used to study the vascular anatomy of the carpal foot pad in dogs and to assess its potential use as a free microvascular flap.

Free tissue transfer of digital food pads for reconstruction of the distal limb in the dog.

Reconstructive procedures used in salvaging distal limb injuries in the dog are reviewed. Techniques employed to resurface the distal weight-bearing surface include local reconstruction using pedicle flap transposition of foot pads. The development of a previously described free microneurovascular digital foot pad flap is reviewed; the experimental results and potential for clinical use of the free flap are discussed.