title: Internal mammary artery perforator (IMAP) flap for tracheostoma reconstruction.
abstract: BACKGROUND
  Tracheostoma reconstruction requires a thin flap to avoid occlusion. Although the deltopectoral flap has been used as a rotational flap for decades, clinical use of a true internal mammary artery perforator island flap has not been reported.
  
  
  METHODS
  In two cases, tracheostoma and anterior neck reconstruction were performed by use of an internal mammary artery perforator flap as a pedicled island flap. One flap was based on the perforator vessels in the second intercostal space and, the other, on the third. Donor sites were closed primarily in both patients.
  
  
  RESULTS
  The internal mammary artery perforator flaps were well perfused in both cases. Both flaps healed uneventfully, with reliable reconstruction of the tracheal stoma and coverage of the anterior neck, although overall prognoses were poor.
  
  
  CONCLUSIONS
  The internal mammary artery perforator flap is a relatively thin and reliable flap for tracheostoma and lower neck reconstruction.
authors.affiliation: Department of Plastic Surgery, Unit 443, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. peirongyu@mdanderson.org
authors.forename: Peirong
authors.initials: P
authors.lastname: Yu
authors.forename: Paul
authors.initials: P
authors.lastname: Roblin
authors.forename: Pierre
authors.initials: P
authors.lastname: Chevray
mesh_terms: D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps / Q000098:blood supply*; D014139:Tracheostomy