Zan Li1, Jie Cui2, Yi Xin Zhang1, L Scott Levin3, Xiao Zhou1, Giuseppe Spinelli4, Davide Lazzeri5, Paolo Persichetti6. 1. Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China. 2. Department of Plastic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China. 3. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 4. Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy. 5. Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy. 6. Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University, Rome, Italy.
Abstract
BACKGROUND: The thoracoacromial artery perforator (TAAP) flap used in its pedicle or in the free microvascular variant is an emerging flap for use as a reconstructive option for the head and neck region. PATIENTS AND METHODS: Between 2006 and 2013, 17 patients with a mean age of 34 years (range, 17-59 years) underwent a TAAP flap procedure for reconstruction of postoncologic and posttraumatic head and neck defects. RESULTS: The pedicle TAAP flap was used to reconstruct neck (n = 5) and hypopharyngeal defects (n = 5); the free TAAP flap was used to resurface lower hemiface (n = 4), tongue (n = 1), and intraoral (n = 2) defects. The flap size ranged from 4.5 × 7 cm to 12 × 17 cm, with a mean thickness of 0.5 cm. The pectoralis major muscle was preserved in all of the cases. All of the patients healed uneventfully. The donor site was closed directly in four cases; a skin graft was used in four patients, and the donor site was covered by a local flap in one case. CONCLUSIONS: Our experience proved the consistent feasibility of the successful use of the TAAP flap for head and neck reconstructions resulting in adequate color matching, texture, and pliability in combination with limited anterior chest wall donor site morbidity. Its hairless nature ensures that this flap is a suitable primary option for inner lining reconstruction of oropharyngeal defects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: The thoracoacromial artery perforator (TAAP) flap used in its pedicle or in the free microvascular variant is an emerging flap for use as a reconstructive option for the head and neck region. PATIENTS AND METHODS: Between 2006 and 2013, 17 patients with a mean age of 34 years (range, 17-59 years) underwent a TAAP flap procedure for reconstruction of postoncologic and posttraumatic head and neck defects. RESULTS: The pedicle TAAP flap was used to reconstruct neck (n = 5) and hypopharyngeal defects (n = 5); the free TAAP flap was used to resurface lower hemiface (n = 4), tongue (n = 1), and intraoral (n = 2) defects. The flap size ranged from 4.5 × 7 cm to 12 × 17 cm, with a mean thickness of 0.5 cm. The pectoralis major muscle was preserved in all of the cases. All of the patients healed uneventfully. The donor site was closed directly in four cases; a skin graft was used in four patients, and the donor site was covered by a local flap in one case. CONCLUSIONS: Our experience proved the consistent feasibility of the successful use of the TAAP flap for head and neck reconstructions resulting in adequate color matching, texture, and pliability in combination with limited anterior chest wall donor site morbidity. Its hairless nature ensures that this flap is a suitable primary option for inner lining reconstruction of oropharyngeal defects. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.