Thoracodorsal artery perforator free flap with vascularized thoracodorsal nerve for head and neck reconstruction following radical parotidectomy with facial nerve sacrifice: Step-by-step surgical technique video.


Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
07 2021
Historique:
revised: 12 01 2021
received: 07 10 2020
accepted: 23 03 2021
pubmed: 6 4 2021
medline: 2 7 2021
entrez: 5 4 2021
Statut: ppublish

Résumé

Oncological surgery of the parotid region sometimes requires the sacrifice of the facial nerve (parotid cancers, extensive skin cancers of the face, soft tissue sarcomas). The sacrificed portion of nerve can be reconstructed by a vascularized nerve graft, especially if the patient must undergo radiotherapy after surgery. In those cases, the facial nerve sacrifice is associated to an important loss of substance from the parotid region (skin, masseter, parotid, and sometimes jaw). Chimeric flap permit the reconstruction at the same time of the external skin, soft tissues for the volume (fat or muscle), nerve, and bone (ramus and angular part of the mandible). An other option was to raise two flaps but it increased the risk of failure (time of surgery, number of anastomosis, etc.). Reconstruction with a chimeric flap appears to be an ideal choice. Based on these observations, we offer our patients at the Gustave Roussy Institute (Villejuif, France) a thoracodorsal artery perforator (TDAP) free flap including the motor nerve of the latissimus dorsi and vascularized by the thoraco-dorsal pedicle, thus allowing reconstruction in a single surgery. The surgical technique is explained with a step-by-step video. Functional outcomes are also shown in the video. The TDAP or chimeric scapulo-dorsal flap with vascularized nerve has many advantages in the facial reanimation of patients suffering from parotid region cancers. This video article explains surgical steps for other teams.

Identifiants

pubmed: 33818833
doi: 10.1002/hed.26701
doi:

Types de publication

Journal Article Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

2255-2258

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

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Auteurs

Pierre Guyonvarch (P)

Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Nadia Benmoussa (N)

Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Antoine Moya-Plana (A)

Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Nicolas Leymarie (N)

Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Maria Lucia Mangialardi (ML)

Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Jean-François Honart (JF)

Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.

Frederic Kolb (F)

Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.
Department of Plastic Surgery, UC San Diego, University of California, San Diego, California, USA.

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