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J Reconstr Microsurg 2014; 30(07): 497-504
DOI: 10.1055/s-0034-1370359
Original Article WSRM Special Topic Issue—Flaps
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Versatility of the Thoracoacromial Artery Perforator Flap in Head and Neck Reconstruction

Zan Li
1   Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China
*   The first two authors contributed equally to this work.
,
Jie Cui
2   Department of Plastic Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China
*   The first two authors contributed equally to this work.
,
Yi Xin Zhang
1   Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China
3   Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
,
L. Scott Levin
4   Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
Xiao Zhou
1   Division of Head and Neck Surgery, Department of Surgery, Hunan Provincial Tumor Hospital, XiangYa Medical School of Central South University, Changsha, Hunan, China
,
Giuseppe Spinelli
5   Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy
,
Davide Lazzeri
6   Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy
,
Paolo Persichetti
7   Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University, Rome, Italy
› Author Affiliations
Further Information

Publication History

05 November 2013

15 December 2013

Publication Date:
15 July 2014 (online)

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Abstract

Background The thoracoacromial artery perforator (TAAP) flap used in its pedicle or in the free microvascular variant is an emerging flap for use as a reconstructive option for the head and neck region.

Patients and Methods Between 2006 and 2013, 17 patients with a mean age of 34 years (range, 17–59 years) underwent a TAAP flap procedure for reconstruction of postoncologic and posttraumatic head and neck defects.

Results The pedicle TAAP flap was used to reconstruct neck (n = 5) and hypopharyngeal defects (n = 5); the free TAAP flap was used to resurface lower hemiface (n = 4), tongue (n = 1), and intraoral (n = 2) defects. The flap size ranged from 4.5 × 7 cm to 12 × 17 cm, with a mean thickness of 0.5 cm. The pectoralis major muscle was preserved in all of the cases. All of the patients healed uneventfully. The donor site was closed directly in four cases; a skin graft was used in four patients, and the donor site was covered by a local flap in one case.

Conclusions Our experience proved the consistent feasibility of the successful use of the TAAP flap for head and neck reconstructions resulting in adequate color matching, texture, and pliability in combination with limited anterior chest wall donor site morbidity. Its hairless nature ensures that this flap is a suitable primary option for inner lining reconstruction of oropharyngeal defects.

Keywords

thoracoacromial artery - perforator flap - anterior chest wall - pectoralis major - head and neck reconstruction
 

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