Submental perforator flap bookshelf

These flaps are based on the submental artery, a branch of the facial artery, and have an anterior neck skin paddle which can be an inconspicuous donor site 8, 9. Submental flap in reconstruction of orofacial defects. Program thursday, august 24, 2017 cadaver labs cadaver lab dissection the ohio state university hamilton hall room 256258 columbus, oh 43210 shuttle service provided from grand event center to ha. Sep 27, 2016 thirtyone facial defects were reconstructed with freestyle local perforator flaps between january 2007 and november 2014. The submental flap provides an alternative technique in orofacial. Perforator flap surgery was described as extravagant and exceptional in those days but it has now become the mainstream reconstructive technique for restoring defects throughout the body. The profunda femoris artery supplies the tissue of the posterior thigh through musculo and septocutaneous perforators. The submental island flap sif is a pedicled flap based upon the submental artery and vein. Diep stands for the deep inferior epigastric perforator artery, which runs through the abdomen. This video demonstrates an axial propellar flap based on the facial artery from the nasolabial area for reconstruction of a nasal side wall defect after basal cell carcioma excision. Patients were followed at monthly interval till 6 months in the postoperative period. Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.

Indeed, controversy exists about the flap s interference with an oncologically sound neck dissection a total of 21 patients with oral cavity cancers over a three year period were. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. The submental perforator flap was useful for reconstructing skin defects on the cheek and the chin, because the site of the submental perforator was stable and raising the flap was easy, and the. This international meeting usually held in amiens france is coming to the united states for the first time. Mar 07, 2019 body lift perforator flap reconstruction uses a flap of tissue from both sides of the lower abdomen diep and the upper buttocks sgap, or hip flap to reconstruct the breasts two flaps per breast, or four flaps in all. Musculocutaneous perforator flaps offer advantages over musculocutaneous flaps, including reduced donor site morbidity, more predictable reconstruction of soft tissue deformities, and a wider variety of flap options. Perforator flaps for breast reconstruction 1st edition. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Craniomaxillofacial trauma and reconstruction will be of interest to specialists working in ophthalmology, oral and maxillofacial surgery, otolaryngology, plastic and reconstructive surgery, dentistry, facial plastic surgery and trauma surgery. The arterial system was perfused with red dye emulsion, while the venous system was infused with blue dye emulsion. The specimens were then subjected to gross observation and. We use cookies on our website, only to provide you with a better service.

We then performed a spy angiography and found 1 or 2 areas which confirmed our suspected doppler locations. Despite its incidence, it is commonly a treatable disease, with a 90% 5year survival rate and an 83% 10year survival rate. This flap can reduce donorsite morbidity significantly and is a good choice for reconstructive surgery. The first ever international course on perforator flaps icpf was organized in gent, belgium, 20 years ago in 1997, when perforator flap surgery was still in its pioneering phase. The submental artery perforator flap is a thin and reliable flap with robust blood supply. Propeller flap for perineal sinus reconstruction youtube. The submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. Breast reconstruction free flaps statpearls ncbi bookshelf. It has been championed as an alternative to the tug flap. The submental flap is gaining popularity as a simple technique for reconstruction of. Using a surgical approach through the neck, marginal mandibulectomy was performed with a. The submental artery flap is a well described axial pattern flap that is increasingly being used in head and neck reconstruction because of its obvious advantages. Perforator flaps for breast reconstruction download.

Raising of microvascular flaps a systematic approach. For the successful reconstruction of facial defects, various perforator flaps have been used in singlestage surgery, where tissues are moved to adjacent defect sites. Preexpanded perforator flaps, an issue of clinics in plastic surgery authors. Submental perforator flap design with a nearinfrared. An otolaryngologist performed closure of septal perforation with a pedicled inferior turbinate mucosal flap. The submental island flap in head and neck cancer faisal m, adeel. The skin territory of the single pedicle submental island flap is as large as 7.

A licence package is needed for accessing this content. What started as a small meeting among friends, has grown into a major international forum where colleagues share their new ideas in the field of perforator. Extended indications and technical refinements ayman a amin1, mostafa a sakkary1, ashraf a khalil2, mohammmed a rifaat1 and sherif b zayed1 abstract background and purpose. Applied anatomy of the submental island flap and its. Please note that this postponement is a fully equivalent replacement for the planned event originally scheduled on march 2020. Definition and introductiondefinition and introduction the submental artery island flap saif is an axial pattern flap introduced by martin et. Currently, 3 million women are living with the disease. Reconstruction of lower face defect or deformity with. Ishihara t1, igata t, masuguchi s, matsushita s, sakai k, ihn h. In this study, we evaluated submental flap design by employing nearinfrared nir fluorescence angiography to identify perforator arteries pas. Feb 28, 2019 overall, only 1516% of these mastectomy patients undergo reconstruction. In this study, we evaluated submental flap design by employing nearinfrared nir fluorescence angiography to identify perforator. The submental island flap is an axial patterned flap based on the submental artery.

Free style perforator flaps for aesthetic facial reconstruction. Doppler identification of perforator vessels preceded preoperative planning and the flap harvesting followed the dissection of perforator vessels. This is an extremely useful local pedicle flap, or it can be used as a free flap. However, oncologically sound neck dissection should be assured. Review of perforator flaps in head and neck cancer surgery.

Filmed under the permission of operating plastic surgeon, dr shaji thomas, head and neck surgical oncology unit regional cancer centre india. Dear friend, 3rd flap reconstruction course on cadaver is postponed to october 15th 17th, 2020 please mark your calendars. It includes chapters and expert commentaries from more than 100 authors and worldrenowned leaders in the field, while brandnew cases and highquality. We then incised through skin and subcutaneous tissue with the knife using electrocautery.

A perforator flap should be named after the nutrient artery or vessels and not after the underlying muscle. The pap flap is an alternative to abdominal based donor sites for autologous breast reconstruction in patients where the abdomen is undesirable or contraindicated. The hybrid submental flap for tongue reconstruction todd c. The design of the soft tissue defect can be transposed to a paper template, which is placed on the submental region. However, its role in composite defects involving the jaw is not clearly defined. Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa, retromolar trigone, parotidectomy defects, and tongue. We also discuss increasingly popular perforator flaps such as the submental flap for the head and neck. Submental lymph node transfer has proved to be an effective approach for the treatment of lymphedema. Submental flap in tongue reconstruction reconstructive. Submental artery islandsubmental artery island flapflap department of oral and maxillofacial surgery vinnitsa national medical university presentation by, patrick royson albertina sheehama supervised by. Development of vascularized submental lymph node vsln flap has encountered dilemmas.

Perforator flaps are described according to the main artery of origin e. It arises deep to the submandibular gland and may be deep 70% or superficial 30% ref 8a to the digastric muscle. Clinical application of submental artery perforator flap in oral and. It includes chapters and expert commentaries from more than 100 authors and worldrenowned leaders in the field, while brandnew cases and high. Submental perforator flap for softtissue reconstruction. The submental flap is a reliable alternative to microsurgical reconstruction of facial deformities, providing an excellent cosmetic match with the contour and color of the face. The submental island flap is a viable reconstructive. Although many free flap procedures have become popular in maxillary reconstruction, these microsurgical methods have certain limitations and risks. Vascularized groin and submental lymph node flaps are both effective surgical options in treating bcrl. Submental perforator flap reconstruction of a malignant. Initial descriptions of perforator flaps in 1989 by koshima and soeda, by using a musculocutaneous flap with an inferior epigastric arterybased skin island for reconstruction of defects involving the floor of mouth and groin, have led to significant additional advancements in the understanding of perforator flaps and vascular anatomy. Perforator flap definition of perforator flap by medical.

The submental flap is a valid option for reconstruction of intraoral soft tissue as well as composite oral defects particularly in elderly patients. This study was to investigate the anatomy and distribution of vascularized submental lymph node vsln flap using magnetic resonance imaging mri and their clinical outcome. To summarize the clinical anatomical features and surgical technique of the submental artery perforator flap smapf, and to evaluate. The use of submental artery perforator island flap without. The patient underwent a second surgical operation under general anesthesia and nasotracheal intubation, consisting of a transverse incision in the neck and harvesting of a submental perforator flap, including the submental vein and artery in the flap. Submental flap is a useful technique for reconstruction of medium to large oral cavity defects. Ramon y cajal of madrid from 2009 to 20 is described, using the records of a total of 20 reconstructions made with submental pedicled flap in patients with intra and extraoral cancers. We then designed a propeller perforator flap around the possible perforators to be used. Preexpanded perforator flaps, an issue of clinics in plastic. Original article the submental island flap in lingual cancer.

Methods between august 2006 and december 2008, 22 patients with lower face defects or deformity underwent reconstruction with pedicled submental artery perforator flaps. This study assessed the reliability of the reverse facial artery submental artery mandibular osteomuscular flap for. Current concept and definition, abstract the term perforator flap, used to define a new type of flap, has recently been introduced in the medical field and in the clinical practice of plastic surgeons. This new edition has been updated to include ten new chapters and extensive updates on all existing chapters. Therefore, deepithelialized variant is introduced to overcome the problem of hair with this. The submental artery island flap sif is an axial fasciocutaneous flap that includes skin, subcutaneous tissue, platysma, and fat and is pedicled on the submental artery and veins figures 1, 2. Baudet editorial comment use of the submental area as donor tissue for reconstruction of facial defects has depended on the description of the anatomy by these authors. Reconstruction of intraoral defects after resection of. To the best of our knowledge, this is the first case in english literature of a submental perforator flap reconstruction of a malignant melanoma defect. An anatomical basis for the flap using a pedicle containing a cervical, nonperforating cutaneous branch of. Dec 20, 2011 the submental flap is gaining popularity as a simple technique for reconstruction of small to moderate size defects of the oral cavity. Supraclavicular artery island flap iowa head and neck.

The submental island flap is a local flap that is simple to raise and is useful for oral and lower face reconstruction of soft tissue defects. Freestyle local perforator flaps for facial reconstruction. Other readers will always be interested in your opinion of the books youve read. If there is a potential to harvest multiple perforator flaps from one vessel, the name of each flap should be based on its anatomical region or muscle. Submental artery island flap in intraoral reconstruction.

Register for trial choose your licence package for full free access during a 14day test period. Breast cancer is a common diagnosis, with 252710 new invasive cases and 63410 in situ cases diagnosed annually, according to the american cancer society data in 2017. The perforator can be at the center, distal or proximal aspect of the flap, depending on the needed orientation in the recipient area. Perforator flap perforator flap meeting 2017 columbus ohio. We collected wet specimens of fresh cadaveric heads from the han chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps. A comparative study between submandibularfacial artery island flaps including perforator flap and submental artery perforator flap.

The submental artery is a consistent branch of the facial artery. Keystone and pedicle perforator flaps in reconstructive. The buccal mucosa 12 patients, tongue 10 patients and floor of mouth 8. Submental flaps for facial and intraoral defect coverage were first described in 1993. This results in an ellipse with its anterior longitudinal arc skirting the lateral border of the latissimus. Here it gives off perforators to the subdermal plexus which perfuses platysma and skin. Freestyle perforator flaps were applied to get better cosmetic facial reconstruction. This low percentage has been attributed to lack of both information and access. Melolabial flap oral cavity reconstruction youtube. The flap dimensions needed are outline, with the perforator on the longitudinal axis of the flap. All women who undergo mastectomy are candidates for consideration of perforator flap breast reconstruction when natural tissue reconstruction is preferred over implant reconstruction. Amiens perforator flap conference in conjunction with the annual ruberg symposium.

We used a doppler to find several perforator candidates. Operating from the central idea that it is necessary to preserve the integrity of the dermatome with its innervation and vascularisation, the. It marks a new era in reconstructive surgery where surgeons are no longer bound by the traditional conventions of flap surgery. The submental island flap for palatal reconstruction. Surgical anatomy of vascularized submental lymph node flap. Ten head specimens 20 sides were collected from han adult cadavers. Vy advancement for chin reconstruction thornton, james fallon m. Submental flap adds a new source of soft tissue in this area, offering benefits of an axial pattern flap with a large paddle size, in the vicinity of the mandible, 14.

The keystone perforator island flap elsevier australia. The positions of these perforators that perfuse the submental is land are. Applied anatomy of the submental island flap and its clinical. To harvest the flap the superior limb of the skin paddle is raised and the lateral incision made through the platysma muscle. With coverage of nearly twice the number of flaps as the previous edition, flaps and reconstructive surgery, 2 nd edition provides trainees and practicing surgeons alike with the detailed, expert knowledge required to ensure optimal outcomes. Seven parts organized anatomically detail flaps used for the headneck, chest, back, abdomen, pelvis, upper extremity, and lower extremity, followed by an. Hair bearing nature of this flap in men makes it less appropriate.

Perforator flaps for breast reconstruction 1st edition by joshua l. Suffix ap artery perforator signifies a true musculocutaneous perforator flap. Applied anatomy of the submental island flap path of the submental artery and accompanying veins. The experience of the department of oral and maxillofacial surgery of the h. Whether youve loved the book or not, if you give your honest and detailed thoughts then people will find new books that are right for them. Elevation of the flap using a perforator pedicle without the use of muscle has been reported, and the submental perforator was demonstrated as being reliable. Many of the contributors to perforator flaps for breast reconstruction have pioneered the procedures presented in their respective chapters. The flap is drained through submental vein into the facial vein. The hybrid submental flap for tongue reconstruction. This book is an essential authoritative guide for plastic surgeons interested in making perforator flap reconstruction part of their practice. The tie between perforator flaps and skin flaps as well as perforator flaps and musculocutaneous flaps is explained.

Submental artery island flap in reconstruction of hard palate. Because the donor vessels have traversed muscle before reaching the fascia, a longer vascular pedicle can be dissected. Suffix s is added if the flap is harvested based on direct septal or fasciocutaneous vessels. The use of submental artery perforator island flap without including digastric muscle in the reconstruction of lower face and intraoral defects. The diep flap is the technique where skin and tissue no muscle is taken from the abdomen in order to recreate the breast. The buccal mucosa 12 patients, tongue 10 patients and floor of mouth 8 patients were the subsites in the oral cavity. Save up to 80% by choosing the etextbook option for isbn. This is the most common procedure performed at our breast center as women generally have excess skin and fat along the lower portion of their abdomen. With coverage of nearly twice the number of flaps as the previous edition, flaps and reconstructive surgery, 2nd edition provides trainees and practicing surgeons alike with the detailed, expert knowledge required to ensure optimal outcomes.

Additional features in this edition include highly useful modifications of elevation of the radial forearm flap as well as new chapters on the rectus abdominis flap, a reliable option for covering deep and extended defects, and the medial sural perforator flap. An assessment of the anatomical basis of the thoracoacromial. True submental artery perforator flap for total softtissue chin. Many new developments have taken place in the field, including the use of local perforator flaps, including freestyle propeller flaps as well as. Threedimensional angiography of the submental artery. Pu and chunmei wang, is devoted to preexpanded perforator flaps. Nasolabial flaps were the first true perforator flaps in the face used to reconstruct perioral defects. Supraclavicular artery island flap for reconstructing defects in the head and neck region. This study solve this problem by securing submental flap to remaining palate by bone sutures. Though not initially recognized as a perforator flap, it is nevertheless the case that this flap is supplied by branches of the submental artery that either perforate the anterior belly of digastric or run immediately anterior or posterior to it. The osu department of plastic surgery is pleased to announce.

In this paper, simultaneous reconstruction of the upper lip and moustache is described. The vsln flap for bcrl provides more significant improvements in limb circumference, lesser total complication rate, a faster flap harvest time, and perhaps the most important factor. Reconstruction of large chin defects requires a flap suitably matched with the contour, colour, and tissue texture of this important aesthetic facial unit. The submental artery perforator flap has a long vascular pedicle and is useful in facial and intraoral reconstructions. The perforator arteries were detected and labeled with a handheld doppler flowmeter. Accurate prediction of submental lymph nodes using. Comparisons of submental and groin vascularized lymph node.