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Updated: Jun 27, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Osteomyocutaneous peroneal artery-based combined flap for reconstruction of composite and en bloc mandibular defects
Ming-Huei Cheng1, Michel Saint-Cyr, Rozina S Ali
1Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. minghueicheng@gmail.com
Background:
The osteomyocutaneous peroneal artery-based combined (OPAC) flap is a refinement of fibula osteoseptocutaneous flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator.
Methods:
Seventeen men underwent composite oromandibular reconstruction using an OPAC flap. Flaps were raised with 1 or 2 skin paddles and 2 to 3 bone segments. In 8 cases, a portion of soleus muscle was included.
Results:
All flaps survived, but partial failure occurred in 2 cases (11.7%). At a mean follow-up of 25.3 +/- 19.4 months, 6 of 12 patients tolerated a regular diet, 5 a soft diet, and 1 a liquid diet. Speech was normal in 2 patients, intelligible in 4, and slurred in 6.
Conclusion:
Advantages of the OPAC flap include a single donor site, 1 pair of recipient vessels, versatile 3-dimensional inset, adequate soft tissue augmentation, and better aesthetic and functional outcomes.