Application of anteromedial thigh flap for the reconstruction of oral and maxillofacial defects.
OBJECTIVE
To discuss the vascular anatomy of the anteromedial thigh (AMT) flap and to evaluate the feasibility of the AMT flap for the reconstruction of oral and maxillofacial defects.


METHODS
A retrospective review was performed of 18 patients who underwent reconstruction of oral and maxillofacial defects with AMT flaps from January 2009 through December 2011 in the Second Xiangya Hospital. Eleven unifoliate AMT flaps were elevated to reconstruct defects of the tongue, soft palate, and floor of the mouth and 7 chimeric anterolateral thigh (ALT) and AMT flaps were harvested to reconstruct through-and-through cheek defects.


RESULTS
The flaps were 4 × 6 to 9 × 11 cm(2). All the AMT flaps were nourished by the descending branch (DB) of the lateral circumflex femoral artery. The cutaneous perforators were derived from the rectus femoris branch of the DB in 15 cases and directly from the DB in the other 3 cases. Postoperatively, all flaps survived completely, without major complications. Of the 18 donor sites, 14 were closed directly, leaving only linear scars, and 4 were closed using full-thickness skin grafts owing to larger defects. All patients were followed for approximately 6 to 30 months, and they were satisfied with the esthetic and functional results of the donor and recipient sites after the reconstruction.


CONCLUSIONS
Because of easy perforator dissection, the AMT flap can be used as an alternative to the ALT flap or harvested with the ALT flap as chimeric ALT and AMT flaps for the reconstruction of oral and maxillofacial defects.
Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
Zhao-Jian
ZJ
Gong
Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
Sheng
S
Zhang
Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
Zhen-Hu
ZH
Ren
Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
Zhao-Fu
ZF
Zhu
Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China.
Jin-Bin
JB
Liu
Professor, Department of Stomatology, Second Xiangya Hospital, Central South University, Changsha, China. Electronic address: wuhanjiang0198@sina.com.
Han-Jiang
HJ
Wu
D000328:Adult; D000368:Aged; D002610:Cheek / Q000601:surgery; D004954:Esthetics; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000637:transplantation; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000601:surgery; D009062:Mouth Neoplasms / Q000601:surgery*; D018482:Muscle, Skeletal / Q000098:blood supply / Q000637:transplantation*; D010157:Palatal Neoplasms / Q000601:surgery; D010160:Palate, Soft / Q000601:surgery; D017060:Patient Satisfaction; D061525:Perforator Flap / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D013848:Thigh / Q000601:surgery; D014062:Tongue Neoplasms / Q000601:surgery; D060053:Transplant Donor Site / Q000601:surgery