Source:Journal of Oral and Maxillofacial Surgery
Author(s): Wei-na Zhou, Lin-zhong Wan, Ping Zhang, Hua Yuan, Hong-bing Jiang, Yi-fei Du
ObjectiveFacial artery perforator flaps (FAPFs) were favored to repair intraoral and perinasal defects with convenient procedure and minimal donor-site morbidity. The purpose of this study was to investigate the anatomic features of FAPFs and presented its clinical application in intraoral reconstruction.Materials and MethodsFive cadaver specimens (10 sides) of head and neck regions and 90 clinical cases (90 sides) of neck dissection were analyzed to explore the facial venous drainage system of FAPFs. In addition, the anatomical features of facial artery and vein as well as marginal mandibular branch of facial nerve were investigated in cadaver specimens. Furthermore, the authors reviewed a series of 33 intraoral reconstruction cases using our designed FAPFs focusing on the flap survival and the types of facial venous drainage system.ResultsBased on cadaveric and clinical observation, facial vein drainage system could be divided into three types: type A drained into internal jugular vein (47%); type B drained into external jugular vein (37%); and type C drained into anterior jugular vein (16%). The mean distances between facial artery and vein at the region of FAPFs pedicle and tip were 2.79±0.51 mm and 10.24±0.70 mm, respectively. Most of the cases with our designed FAPFs obtained satisfactory aesthetic and functional outcomes, while three cases presented with venous congestion, all of which were encountered with type C facial vein drainage.ConclusionThis study improved the understanding of FAPFs anatomic features and clinical application in intraoral reconstruction. Our designed FAPFs could achieve a preferable intraoral defect reconstruction and type C facial vein drainage might be a risk factor to the flap survival.
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