title: Three-dimensional combined flaps for reconstruction of complex facial defects following cancer ablation.
abstract: Instead of conventional multiple-paddle or folded free flaps, the authors introduce three types of free combined tissue transfers for cosmetic and functional restoration of massively large facial defects. Three cases reported here were repaired with combined flaps consisting of two or more tissues, such as combined free anterolateral thigh flaps and vascularized muscle or bone grafts. In cases with complex defects in the upper lateral face, facial dynamics were also reconstructed with a free vascularized innervated muscle graft. A complex hemifacial defect involving the orbita and nose can be easily reconstructed with free osteocutaneous flaps in two stages. For complex craniofacial defects, the concept of combined chimeric tissue transfers is most suitable. The ideal pedicle vessels for the combined flaps are considered to be those in the lateral circumflex femoral system, which is far from the head and neck regions, because flap elevation can proceed simultaneously with tumor resection.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kawasaki Medical School, Okayama, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Koshima
authors.forename: M
authors.initials: M
authors.lastname: Hosoda
authors.forename: T
authors.initials: T
authors.lastname: Moriguchi
authors.forename: R
authors.initials: R
authors.lastname: Ishii
authors.forename: Y
authors.initials: Y
authors.lastname: Orita
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000601:surgery; D009296:Nasal Cavity; D009669:Nose Neoplasms / Q000601:surgery; D013524:Surgical Flaps / Q000379:methods*