A new design of facial artery perforator flaps for the reconstruction of small- to medium-sized intraoral defects.
OBJECTIVE
The aim of this study was to investigate the reliability and outcomes of a new design of facial artery perforator flaps, extending from the angle of the mouth to the border of the mandible, for the reconstruction of small- to medium-sized intraoral defects.


METHODS
The technique had been used in 23 patients between February 2009 and August 2012. The locations of intraoral defects included the tongue, the floor of the mouth, the inferior gingival mucosa, and the sublingual gland. All flaps were monitored for complications including skin loss and ischemia. The functions of appearance, swallowing, and speech were assessed 6 months after operation with the University of Washington Quality of Life Questionnaire.


RESULTS
All flaps presented with satisfactory results except for one, which demonstrated superficial tip necrosis that settled after conservative treatment. The follow-up period ranged from 6 to 12 months, and 1 patient died as a result of pulmonary metastasis, and 3 patients underwent second surgery because of local tumor recurrence (2patients) and cervical recurrence (1 patient). Nineteen patients were assessed with the University of Washington Quality of Life Questionnaire, and the mean (SD) scores of appearance, swallowing, and speech were 57.89 (14.45), 83.68 (19.98), and 81.58 (23.16), respectively.


CONCLUSIONS
This design of facial artery perforator flaps could provide an efficient and cost-effective method for reconstruction of small- to medium-sized intraoral defects with a low surgical morbidity and satisfactory levels of quality of life.
From the Departments of *Oral and Maxillofacial Surgery, and †Polyclinic Dentistry, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China.
Yi-fei
YF
Du
Wei-na
WN
Zhou
Jie
J
Li
Hong-bing
HB
Jiang
Hua
H
Yuan
Lin-zhong
LZ
Wan
D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000637:transplantation; D003679:Deglutition / Q000502:physiology; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D005893:Gingivoplasty / Q000379:methods; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000601:surgery; D009062:Mouth Neoplasms / Q000601:surgery*; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D013060:Speech / Q000502:physiology; D013363:Submandibular Gland / Q000601:surgery; D014059:Tongue / Q000601:surgery; D016896:Treatment Outcome