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Myofascial iliac crest flap for reconstruction of combined oral mucosa-mandibular defects: A single-centre experience - 13/06/22

Doi : 10.1016/j.jormas.2022.06.005 
Kai-xiong Li a, 2, 2, , Yu-xun Ye a, b, 1, , Yi Bai c, Yan-fang Sun a, Jun Jia a, b, Xue-peng Xiong a, b,
a Department of Oral and Maxillofacial-Head and Neck Oncological Surgery, Hospital of Stomatology, Wuhan University, Wuhan, China 
b The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China 
c Department of Oral Implantology, Hospital of Stomatology, University of Wuhan, Wuhan, China 

Corresponding author at: Department of Oral and Maxillofacial-Head and Neck Oncological Surgery, Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, Hubei 430079, PR China.Department of Oral and Maxillofacial-Head and Neck Oncological SurgeryHospital of StomatologyWuhan University237 Luoyu RoadWuhanHubei430079PR China
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Monday 13 June 2022

Abstract

Background

Deep circumflex iliac artery (DCIA) myofascial iliac crest flap has been used for combined oral mucosa-mandibular defects reconstruction. The bone component of this composite flap can reconstruct the mandible with superior contour match, and the muscle fascia which used for repairing the oral mucosa defect will transform into an oral mucosa-like appearance. To explore its scope of clinical application and how the fascia transformed into oral mucosa will give surgeons flexibility to reconstruct the combined oral mucosa-mandibular defects.

Methods

A retrospective review of 18 patients who received combined oral mucosa-mandibular defects reconstruction with DCIA myofascial iliac crest flaps from Dec 2016 to Dec 2020 was performed. The characteristics of the mandibular defects and the flaps were recorded. The postoperative dynamic changes of one graft's fascia were observed from serial photographs.

Results

All myofascial iliac crest flaps survived successfully. The bone grafts were from 4.0 to 9.5 cm (mean 7.6 ± 1.5 cm) in length and from 2.0 to 3.5 cm (mean 2.7 ± 0.4 cm) in height. The sizes of fascia were from 13.5 to 48.0 cm2 (mean 27.2 ± 9.4 cm2). The grafted fascia firstly changed into a yellow pseudomembrane-like appearance, and then experienced muscle oedema before finally transformed into an oral mucosa-like appearance at about 60 days after operation.

Conclusion

Myofascial iliac crest flap is a good option for reconstruction of combined oral mucosa-mandibular defects because of its excellent bone and oral mucosa matches.

El texto completo de este artículo está disponible en PDF.

Key Words : Mandibular reconstruction, Surgical flaps, Reconstructive surgical procedures, Fascia, Head and neck neoplasms

Abbreviations : DCIA, ASIS, CBCT


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© 2022  Publicado por Elsevier Masson SAS.
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