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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
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Retromolar trigone reconstructive surgery: prospective comparative analysis between free flaps.

Emanuele Cigna1, Maria Ida Rizzo, Antonio Greco

  • 1Plastic Reconstructive Surgery Unit, La Sapienza University of Rome, Rome, Italy.

Annals of Surgical Oncology
|August 28, 2014
PubMed
Summary
This summary is machine-generated.

The anterolateral thigh (ALT) perforator flap offers superior cosmetic results and less scarring compared to the radial forearm (RF) flap for reconstructing defects after retromolar trigone cancer surgery.

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Area of Science:

  • Head and Neck Surgery
  • Surgical Oncology
  • Microsurgery

Background:

  • Retromolar trigone (RMT) tumors are rare, aggressive malignancies requiring extensive surgical resection.
  • Reconstruction of oral cavity defects post-RMT resection presents significant aesthetic and functional challenges.
  • Free radial forearm (RF) and anterolateral thigh (ALT) flaps are primary choices for intraoral defect repair, yet comparative evidence for RMT reconstruction is limited.

Purpose of the Study:

  • To evaluate and compare the microvascular reconstruction outcomes of free radial forearm (RF) flaps versus anterolateral thigh (ALT) perforator flaps after retromolar trigone (RMT) cancer resection.
  • To assess differences in morphofunctional outcomes, complications, and patient satisfaction between RF and ALT flaps in RMT defect reconstruction.

Main Methods:

  • A prospective study involving 30 patients with RMT cancer who underwent oropharyngectomy and microvascular reconstruction.
  • Patients were divided into two groups: free RF flap reconstruction and ALT perforator flap reconstruction.
  • Outcomes analyzed included flap viability, complications, scarring, cosmetic appearance, sensory disturbances, range of motion, disease-specific items, and patient satisfaction, with statistical analysis performed.

Main Results:

  • Statistically significant differences (p < 0.05) were observed between RF and ALT groups regarding donor site complications, cosmetic appearance, and scar evaluation.
  • The RF group showed a higher incidence of donor site complications and less favorable cosmetic and scar outcomes compared to the ALT group.
  • Manual dexterity was impaired in 33.3% of patients in the RF group on the operated donor side.

Conclusions:

  • The free ALT perforator flap demonstrates superior aesthetic and scarring outcomes compared to the free RF flap for intraoral reconstruction following RMT cancer resection.
  • The findings suggest that the ALT flap is a preferable option for achieving better functional and cosmetic results in these complex reconstructions.