Reconstruction Of Cheek Defects Research Articles

Modified Mustardé rotation cheek flap with full-thickness skin graft for reconstruction of large cheek defects.

Modified Mustardé rotation cheek flap with full-thickness skin graft for reconstruction of large cheek defects.

V-Y advancement flap combined with full thickness skin graft for reconstruction of large cheek defects.

V-Y advancement flap combined with full thickness skin graft for reconstruction of large cheek defects.

A lower eyelid and cheek defect reconstruction.

A 91 years old woman presented with a recurrent cutaneous squamous cell carcinoma (CSCC) involving the right lower eyelid and cheek. Recurrence occurred after one month from an incomplete surgical excision: histology reported a tumor infiltration of the subcutaneous tissue and deep margin. [...]

A retrospective study of flap selection for through-and-through cheek defect reconstruction

This retrospective study compared different reconstructive strategies for through-and-through cheek defects arising from radical resection of buccal squamous cell carcinoma. Based on clinical data collected from March 2016 to September 2021

Extended Pedicled Perforator Plus Submental Flap for Large Cheek Defect Reconstruction.

Eight patients aged 58 to 81 years with cheek cancer presented to the surgery department at the Benha University Hospital in Egypt, from May 2019 to October 2021 for the removal of their tumors and reconstruction of the resulting defects, using the extended submental perforator plus pedicled artery flap. The average blood loss was 250 cm3 (range: 50-400 cm3). The average operation took 3 hours to complete, including excision and rebuilding (a range of 2.5 to 3.5 hours). The length of the postoperative hospital stay was 2 to 4 days. Fortunately, there was no complete flap loss; nonetheless, distal flap necrosis in one case left a raw area, which was allowed to heal naturally, and hemorrhages in two cases were conservatively handled. For the reconstruction of cheek abnormalities, the submental flap is a viable alternative, particularly in older patients or patients whose overall health has declined and who need less severe therapies and quicker surgery. The submental flap, which conceals the donor site, provides a dependable supply of skin for facial resurfacing with excellent color, shape, and texture matching. The flap is quick, and easy to raise.

Bi-Paddle Pectoralis Major Myo-Cutaneous Flap: A Step by Step Approach

We present a case of reconstruction of a large full thickness cheek defect as a result of cancer ablative surgery. This defect was reconstructed primarily by bi-paddle pectoralis major myo-cutaneous (PMMC) flap. This technique is anatomically sound, technically easy with short learning curve and also reproducible. One has to be careful, not to place more than one third of the skin paddle outside the muscle. This method of reconstruction is an alternative where microvascular free tissue transfer is contraindicated due to medical comorbidity or is not feasible due to either lack of the expertise or infrastructure. It is extremely useful in salvage in cases, in cases of the failure of microvascular flap, in selected large full thickness oral cavity lesions. However, the limitations of this method include loss of nipple area and technical difficulty in females and obese patients.

Pedicled Forehead Flap for Reconstruction of Cheek Defect: A Novel Surgical Case Report

Oral cancers are considered slow killer disease. Every year 3,00,000 cases are diagnosed worldwide. Public awareness has been a great challenge to educate people to avoid harmful oral habits to prevent oral cancer. People are not aware about life threatening complications such as death due to oral cancer. Oral cancer is the eighth most common malignancy in India and third most common malignancy in South East Asia. Buccal mucosa carcinoma spreads rapidly and invades deeply to underlying tissues and has high recurrence rate. Surgical resection is more challenging if the tumour invade adjacent anatomical structures and reconstruction should be planned according to extent of tumour resection. Regional flaps are used for oral cavity after tumour resection such as radial forearm flap, deltopectoral flap, pectoralis major flap, latissimus dorsi flap, transverse rectus abdominis myocutaneous flap, trapezius flap. In this case report folded forehead pedicle flap was used to provide both inner and outer linings of the cheek defect following buccal mucosa tumour resection.

Full cheek defect reconstruction using ALTF versus RFF: Comparison of quality of life, clinical results, and donor site morbidity.

This study aimed to compare the quality of life (QOL) of patients, clinical results of the recipient site, and morbidities of the donor site between the use of free anterolateral thigh flaps (ALTFs) and radial forearm flaps (RFFs) for reconstruction of full cheek defects following tumor resection. We retrospectively reviewed 52 patients who underwent reconstruction of full cheek defects using free ALTFs and free RFFs following tumor ablation at our center. The range of mouth opening, speech, swallowing, facial appearance, donor site complications, and subjective symptoms based on the University of Washington Quality of Life (UW-QOL) questionnaire findings were assessed in the ALTF and RFF groups at 3, 12, and 36months after surgery. Quality of life, range of mouth opening, facial appearance, mood and anxiety, donor site appearance, subjective feeling, and functional impairment were better in the ALTF group than in the RFF group based on the physical examination findings and questionnaire scores. This study found better QOL and better functional results at the recipient site and minor morbidities at the donor site with the use of free ALTFs in the reconstruction of full cheek defects.

Narayanan Flap in Primary Reconstruction of Large Cheek Defects Following Cancer Resection

Narayanan Flap in Primary Reconstruction of Large Cheek Defects Following Cancer Resection

Single-Skin Paddle Anterolateral Thigh Free Flap with Ileotibial Tract for Internal Lining in Reconstruction of Full-Thickness Cheek Defect.

Single-Skin Paddle Anterolateral Thigh Free Flap with Ileotibial Tract for Internal Lining in Reconstruction of Full-Thickness Cheek Defect.

Modified Cervicofacial Flap for Large Cheek Defect Reconstruction under Local Anesthesia

The cervicofacial flap was first described in 1969. For the past several years, it has been the flap of choice for the reconstruction of facial defects especially cheek defects. In recent years, with the advent of microvascular free flap tissue transfer, the use of a cervicofacial flap has been sparse. This article highlights the importance and application of locoregional flaps such as a cervicofacial flap in the reconstruction of soft tissue defects on a face. This case was unique from the reconstruction point of view. An 81-year-old patient presented to us with a long standing ulcerated growth in his left cheek which was neglected due to lack of symptoms and his poor financial condition. Clinically, the extent was defined from the suborbital skin region till the mid cheek region and medially from the lateral nasal crease up to the cheek prominence area. An initial biopsy suggested basal cell carcinoma. The lesion was excised, and a 4.5 × 5.5 cm defect was reconstructed using a modified “cervicofacial” flap under local anesthesia. Our experience shows that this technique is a reliable, easy to harvest flap with good outcomes. Moreover, it can be utilized in those candidates not suitable for a free flap procedure under general anesthesia.

Clinical application of folded free radial forearm flaps for reconstruction of full-tickness cheek defects after resection of buccal carcinoma

Objective:To investigate the therapeutic effect of folded free radial forearm flaps (RFF) for reconstruction of full-tickness cheek defects after the resection of buccal carcinoma.Method:Seventeen cases of buccal carcinoma received radical neck dissection with cheekectomy and mandibulectomy, and the folded RFF to reconstruct full-tickness cheek defects simultaneously. Preoperative Allen test, ultrasonic doppler blood flow meter examination or computed tomography angiography confirmed good vascular condition of the forearm. Result: RFF were obtained from all patients, and completely survived. During the follow-up period of 6-36 months, the lateral morphology of the cheek was restored well and the mouth opening is normal. Language and swallowing function recovered well, without salivation or cheek biting. There were no obvious complications in the donor site. One case（T₃N₁M₀）died of pulmonary metastatic carcinoma a year later. Conclusion:The success rate is high and the morphology and function recovered well of the folded RFF for reconstruction of full-tickness cheek defects, so it is a reliable method to reconstruct full-tickness cheek defects after the resection of buccal carcinoma.

Total Cheek Reconstruction Using the Pre-Expanded Medial Arm Flap With Functional and Aesthetic Donor Site Closure.

This clinical study aimed at introducing a reconstructive method for total cheek soft tissue defects using the pre-expanded medial arm flap and to maximally reduce donor site morbidities simultaneously. A retrospective review of data was performed for 3 patients requiring the pre-expanded medial arm flap to reconstruct total cheek defects. The donor site in the medial arm was primarily closed using a pedicle parascapular or thoracodorsal artery perforator flap. All patients had a total unilateral cheek defect after lesion removal. Three pre-expanded medial arm flaps measuring 17 × 11 cm, 22 × 15 cm, and 20 × 15 cm were separately used for cheek defect reconstruction. The donor sites in the medial arm were closed using a pedicle parascapular flap, measuring 22 × 9.5 cm, and 2 pedicle thoracodorsal artery perforator flaps, measuring 22 × 10 cm and 23 × 10 cm. No major complications occurred in any patient. Patients were followed up for 3, 12, and 18 months. Patients (and/or their family members) were satisfied with the final outcomes. Total cheek defect reconstruction using a pre-expanded medial arm flap, with the donor site closed using a pedicle axial back flap, can not only provide sufficient tissue for cheek resurfacing, but also guarantee primary donor site closure and could be an alternative reconstructive option for patients who have a total cheek defect.

Approach to Reconstruction of Cheek Defects.

The cheek is the largest facial unit with a prominent position on the face. Trauma, burns, and the resection of skin cancers constitute common sources of injury, potentially resulting in defects that, through natural healing, produce noticeable scarring. Surgical repair focuses on the reformation of three-dimensional geometries, proper establishment of symmetry, and the minimization of color and texture discrepancies to the surrounding. Defects located in this region may extend to the orbital, nasal, or buccal units and cause unique structural and functional disturbances. Furthermore, without appropriate repair, full-thickness defects involving the buccal mucosa may result in oral dysfunction. In this article, the authors provide a framework to approach various cheek defects and provide a review of the host of ideologies and techniques.

Cervicofacial Rotation Advancement Flap in Cheek Reconstruction

Introduction: The Cervicofacial rotation advancement flap (CRAF) is a random-pattern flap that provides an excellent match for cheek reconstruction. In this report, the authors review their experience with this flap and present their advantages in order to expand the awareness and promote the application.Methods: A retrospective analysis of reconstruction of cheek defects using CRAF was performed in 12 patients. Data on patient demographics; diagnosis, defect type, and outcome were collected. Results: These patients included 07 male and 05 female; they ranged in age from 56 to 88 years, with a mean age of 67 years.05 patients used tobacco and one patient had a history of radiation. On histopathological examinations of the specimen, 03patients had squamous cell carcinoma, and 09 patients had basal cell carcinoma. The mean defect size was 40cm² [range 10 to 67cm²]. The mean follow-up was 06 months [0 to 24 months]. One patient was lost to follow-up after suture removal. As complication 01 patient had flap necrosis No facial nerve injury was observed. All patients were pleased with the outcome of the Cosmetic results. Conclusion: Cervicofacial flap provides a technically simple, reliable, safe, efficient, and cosmetic means to reconstruct defects of the cheek.

Bilateral Submental Flap: An Innovative Modification.

Early management of premalignant lesions like oral submucous fibrosis cannot be underestimated in context of prevention and control of oral malignancies. Soft tissue reconstruction of the oral cavity and face is a complex undertaking. Several flaps local and distant as well as microvascular are available, each with their pros and cons. Microvascular free flaps lay a considerable burden on resources, expertise, increased operating time, and logistics. Simple and technically reproducible alternatives are needed to tackle these issues, more so in developing countries like ours. Submental flap is based on a large branch of the facial artery and was initially described in 1993 by Martin et al as an excellent option in head and neck reconstruction. We describe innovative modification of the submental flap based on concept of bilateral presence of facial and submental vasculature and thus can be used for bilateral cheek reconstruction. We use pedicled bilateral submental flap (BSF) by dividing the oval skin paddle obliquely, maintaining needed length. The best use of the BSF is in reconstruction of cheek defect, after surgical release of grade IV oral submucous fibrosis, a debilitating affliction commonly affecting young productive adults and seen in Indian subcontinent. The technique was used successfully in 20cases with minor complications.

Reconstruction design before tumour resection: A new concept of through-and-through cheek defect reconstruction

ObjectiveTo explore a new method of reconstruction of through-and-through cheek defects and to evaluate this method’s efficacy and patient prognosis. Materials and methodsThis retrospective study included 70 patients who underwent reconstruction of through-and-through cheek defects. The surgical approach, design of facial skin incisions, selection and design of flaps, postoperative quality of life and prognosis of patients were recorded and reported. ResultsPostoperative quality of life gradually increased over time, and the mean scores of University of Washington Quality of Life (UW-QOL) Questionnaire was more than 80 at 1-year postoperatively. The appearance, oral competence, chewing, swallowing, speech and other oral functions were well recovered in about 90% of patients at 1-year postoperatively. ConclusionThis new idea of reconstruction before tumour resection, brings the effect of plastic and reconstructive surgery to a new height.

Reconstruction of full-thickness cheek defect with a folded cervico-pectoral cutaneous flap following ablation of advanced oral cancer in elderly patient

Reconstruction of full-thickness cheek defects involving both the oral lining and the external facial skin following ablative surgery remains a difficult task. Free flap reconstruction is the main modality of treatment, but sometimes there is a reluctance to use it in elderly patients with several comorbidities for an increased risk of non-cancer-related cause of death. This article describes a folded cervico-pectoral fasciocutaneous flap that has been used to reconstruct a full-thickness cheek defect in elderly patients. Moreover, surgical technique and aesthetic results 2 years after surgery are discussed in this article. Currently, after 2 years, the patient is free of disease and enjoys good health. In conclusion, folded cervico-pectoral fasciocutaneous flap is a fast and practical technique for reconstructing full-thickness cheek defects after tumor excision. The flap was straightforward to perform and reliable in both blood supply and cosmetic outcome, and it provides a good alternative to free flaps for cheek and upper neck reconstruction of elderly patients. Level of Evidence: Level V, therapeutic study.

Reconstruction of full-thickness buccal defects with folded radial forearm flaps

Our goal was to describe our experience of the folded radial forearm flap (RFF) flap in through-and-through buccal defect reconstructions.Patients who had received a folded RFF flap for full-thickness cheek defect reconstruction were included. The flap success rate and functional results were evaluated.Six patients were enrolled. All flaps survived totally without any complication; the mean flap size was 75.5 (range 32–135) cm2. The mean mouth-open width was 4.2 (range 3.5–4.7) cm at 6 months after operation. All patients were satisfied with the appearance and were capable of maintaining a regular oral diet, and no patients complained of an inability to eat in a public setting, microstomia, or drooling.Radial forearm flap was a reliable method for through-and-through buccal reconstruction with high success rate and good functional result.

Fold anterolateral thigh flap in through-and-through cheek defect reconstruction following oral cancer ablation

Objective To investigate the outcome of fold anterolateral thigh flap in through-and-through defect reconstruction following oral cancer ablation. Methods From January, 2011 to December, 2013, 23 patients were performed through-and-through defect reconstruction following oral cancer ablation with free fold anteorlateral thigh flap including 15 cases of buccal mucosa carcinoma, 2 cases of basal cell carcinoma of buccal skin, 4 cases of gingiva carcinoma, 1 case of recurrent parotid duct carcinoma and 1 case of buccal rhabdomyosarcoma. The defects ranged from 3.5 cm × 7.0 cm~7.0 cm × 12.0 cm and the flaps ranged from 4.0 cm × 12.0 cm-8.0 cm × 20.0 cm in size, and were adjusted to the through-and-through defect of the buccal area. The outcome of reconstruction was evaluated by considering the facial appearance, the swallowing and the speech function, the ranges of mouth opening and patient prognosis. Results All of the 23 cases transplanted flaps survived well, the donor sites were closed directly, without donor-site morbidity. All patients were satisfactory with their facial appearance, occlusion and swallowing and speech function. Fifteen patients performed post-operative radiotherapy. The follow-up period was 8-45 months(average 22 months), 5 patients performed salvage surgery for tumor recurrence and 2 patients died of re-recurrence, 1 patient survival with disease and all other patients were alive without disease. Conclusion The fold anterolateral thigh flap is large and suitable and reliable for the through-and-through defect reconstruction following oral cancer ablation. Key words: Oral cancer; Through-and-through defect; Anterolateral thigh flap; Transplantation