Evaluation of anterolateral thigh flap dimensions with virtual flap models. Issue 2 (February 2023)

• Record Type: Journal Article
• Authors: Ooms, M.; Beckmann, L.; Ayoub, N.; Raith, S.; Puladi, B.; Houschyar, K.; Hölzle, F.; Modabber, A.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 52:Issue 2(2023)
• Page Start: 168
• Page End: 174
• Publication Date: 2023-02
• Subjects: Reconstructive surgical procedure -- Free tissue flaps -- Transplant donor site -- Leg -- Thigh; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2022.05.004
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Free flaps are commonly used for head and neck reconstruction. However, flap dimensions are still evaluated by visual and tactile assessment. The aim of this study was to enable preoperative planning of flap dimensions for soft tissue reconstruction based on clinical parameters. Computed tomography records from 230 patients dated from 2009 to 2019 were analysed retrospectively. A virtual, three-dimensional anterolateral thigh flap model was standardized, aligned to segmented leg models in two positions, and flap thicknesses and volumes were determined. Associations of flap thickness and volume with clinical parameters were evaluated, and an approximative calculation method was derived. The laterally positioned anterolateral thigh flap showed an average (interquartile range) thickness of 15.6 mm (8.7 mm) and volume of 1.5 cm 3 (0.9 cm 3 ) per cm 2 . The medially positioned anterolateral thigh flap showed an average (interquartile range) thickness of 16.3 mm (8.7 mm) and volume of 1.6 cm 3 (0.9 cm 3 ) per cm 2 . For both flap positions, leg circumference was the strongest predictor of flap thickness (β = 0.545, P < 0.001 and β = 0.529, P < 0.001) and flap volume (β = 0.523, P < 0.001 and β = 0.480, P < 0.001). Flap dimensions can be calculated based on leg circumference, and this preoperative planning of flap dimensions can help the surgeon to select the appropriate flap.