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Updated: Aug 9, 2026
Porcine As a Training Module for Head and Neck Microvascular Reconstruction
Published on: September 29, 2018
Internal mammary artery perforator (IMAP) flap for tracheostoma reconstruction
Peirong Yu1, Paul Roblin, Pierre Chevray
1Department of Plastic Surgery, Unit 443, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. peirongyu@mdanderson.org
Background:
Tracheostoma reconstruction requires a thin flap to avoid occlusion. Although the deltopectoral flap has been used as a rotational flap for decades, clinical use of a true internal mammary artery perforator island flap has not been reported.
Methods:
In two cases, tracheostoma and anterior neck reconstruction were performed by use of an internal mammary artery perforator flap as a pedicled island flap. One flap was based on the perforator vessels in the second intercostal space and, the other, on the third. Donor sites were closed primarily in both patients.
Results:
The internal mammary artery perforator flaps were well perfused in both cases. Both flaps healed uneventfully, with reliable reconstruction of the tracheal stoma and coverage of the anterior neck, although overall prognoses were poor.
Conclusion:
The internal mammary artery perforator flap is a relatively thin and reliable flap for tracheostoma and lower neck reconstruction.
