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Complex Scalp Reconstruction in Moyamoya Disease Using Distant Flap After Free Tissue Transfer Failure.

Rah Yoon Kim1, Chang Jun Lee, Sang Oon Baek

  • 1Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

The Journal of Craniofacial Surgery
|January 17, 2025
PubMed
Summary

Distant thenar flaps offer a viable solution for complex head and neck reconstructions when traditional microvascular surgery fails or is not feasible. This case study demonstrates their successful application in repairing a persistent scalp defect after initial flap necrosis.

Keywords:
Distant flapmoyamoya diseasereconstructionscalp

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Head and Neck Surgery

Background:

  • Autologous tissue reconstruction, especially free tissue transfer with microvascular anastomosis, is a preferred method for large head and neck defects.
  • Conventional microvascular techniques may not be suitable for all complex reconstructive challenges.

Purpose of the Study:

  • To present a case study on the successful use of a distant thenar flap for head and neck reconstruction.
  • To highlight the utility of distant flap techniques in cases where microvascular surgery is not feasible or has failed.

Main Methods:

  • A 55-year-old female patient with a large scalp defect following surgical necrosis was treated.
  • Initial reconstruction with a free anterolateral thigh flap resulted in partial necrosis.
  • A subsequent reconstruction was performed using a distant thenar flap.

Main Results:

  • The distant thenar flap successfully reconstructed the persistent 2x4 cm² scalp defect.
  • The patient experienced a full recovery with no postoperative complications.
  • This case underscores the effectiveness of distant flap reconstruction.

Conclusions:

  • Distant flap techniques remain a valuable option in reconstructive surgery, particularly for complex head and neck defects.
  • The successful application of a distant thenar flap demonstrates its continued relevance and efficacy.
  • This approach is crucial when microvascular surgery is contraindicated or has been unsuccessful.