Anterior Branch of the Transverse Cervical Artery Pedical Perforator Flap: A Versatility Flap
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i3.3814
Abstract
Background: To describe our experience in the use of the anterior perforator of the transverse cervical artery flap (ap-TCAF), to describe the technique for the reconstruction of defects in the head and neck. Methods: From August 2018 to April 2022, two patients were surgically treated for squamous cell carcinoma of the head and neck and underwent reconstruction using the ap-TCAF. The surgical procedure was photographed and described here. Results: The ap-TCAF was used in the first patient to reconstruct a neck defect resulting from an extended laryngopharyngectomy with resection of anterior cervical skin. In the second patient, the same flap was used to reconstruct a defect between the pharynx and the skin, as well as a communication between the trachea and pharynx. Conclusions: These flaps demonstrate exceptional versatility in clinical applications. Their thin profile with axial vascularization facilitates efficient perfusion while maintaining low tissue bulk, enabling rapid elevation during procedures. Notably, their pliability characteristics are comparable to those of radial forearm free flaps, making them suitable for complex reconstructive requirements.
Keywords
anterior perforator of the transverse cervical artery flap (ap-TCAF); head and neck reconstruction; squamous cell carcinoma; pharynx defect reconstruction
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[8] Song H, Chai J. Pre-expanded Transverse Cervical Artery Perforator Flap. Clin Plast Surg. 2017;44(1):41-47.
[9] Luca N, Santana MJ, Festa BM, Collurà F, Righini S. Transverse cervical artery perforator flap: standardized surgical technique and multiple reconstructive opportunity in head and neck surgery. Ann Plast Surg. 2017;79(6):577-582.
[2] Wang L, Ma Ch, Shen Y, MA JF, et al. Transverse cervical artery anterior perforator flap for head and neck oncological reconstruction: Preliminary study. Head Neck. 2021;43(11):3598-3607.
[3] Pallua N, Wolter TP. Moving forwards: the anterior supraclavicular artery perforator (a-SAP) flap: a new pedicled or free perforator flap based on the anterior supraclavicular vessels. J Plast Reconstr Aesthet Surg 2013;66(4):489-496
[4] Portnoy WM, Arena S. Deltopectoral island flap. Otolaryngol Head Neck Surg. 1994;111(1):63-69.
[5] Mirghani H, Leymarie N, Amen F, Qassemyar Q et al. Pharyngotracheal fistula closure using the internal mammary artery perforator island flap. Laryngoscope. 2014;124(5):1106-1111.
[6] Hamidian JA, Horen SR, Miller EJ, Konofaos P. A comprehensive review on the supraclavicular flap for head and neck reconstruction. Ann Plast Surg. 2022;88(6):e20-e32.
[7] Chin T, Ogawa R, Murakami M, Hyakusoku H. An anatomical study and clinical cases of 'super-thin flaps' with transverse cervical perforator. Br J Plast Surg. 2005;58(4):550-5.
[8] Song H, Chai J. Pre-expanded Transverse Cervical Artery Perforator Flap. Clin Plast Surg. 2017;44(1):41-47.
[9] Luca N, Santana MJ, Festa BM, Collurà F, Righini S. Transverse cervical artery perforator flap: standardized surgical technique and multiple reconstructive opportunity in head and neck surgery. Ann Plast Surg. 2017;79(6):577-582.
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