Superficial circumflex iliac perforator flaps for maxilla defects with intraoral anastomosis or pedicle elongation techniques

BMC Oral Health. 2024 Oct 27;24(1):1302. doi: 10.1186/s12903-024-05073-0.

Abstract

Background: To evaluate the feasibility and safety of the superficial circumflex iliac perforator flap (SCIP) for maxillary reconstruction with intraoral anastomosis, pedicle elongation, and super-microsurgery techniques to overcome its anatomical shortcomings due to the attractive merits of the flap.

Methods: Patients who underwent reconstruction of maxillary defects with SCIPs from July 2020 to December 2022 were included. Intraoral anastomosis, pedicle elongation, and super-microsurgery were performed during surgery with or without a neck incision. The sizes, pedicle lengths, inner calibres of vessels, complications and flap survival statuses were recorded.

Results: A total of 12 patients were included, with 3 males and 9 females, and the median age was 45 years, ranging from 14 to 74 years. There were 5 class IIa and 7 class IIb defects, 6 cases underwent maxillary defect reconstruction via SCIPs with intraoral anastomosis, and the other 6 cases with distally design and/or de-epidermis pedicle elongation. Super-microsurgery interventions were needed in 5 patients. The size ranged from 3 cm×4 cm to 6 cm×8 cm. The pedicle length ranged from 4 cm to 12 cm, with a median of 6 cm. The inner caliber of the arteries ranged from 0.7 mm to 2 mm, with a median of 1 mm, and the veins ranged from 1.5 mm to 4 mm, with a median of 2.5 mm. All the flaps survived, and no donor site complications occurred.

Conclusion: Superficial circumflex iliac perforator flaps can be regarded as feasible and safe choices for maxillary defects with the support of intraoral anastomosis, pedicle elongation and super-microsurgery.

Keywords: Free tissue flaps; Iliac artery; Microsurgery; Rehabilitation; Surgical anastomosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical* / methods
  • Feasibility Studies
  • Female
  • Humans
  • Iliac Artery / surgery
  • Iliac Artery / transplantation
  • Ilium / surgery
  • Ilium / transplantation
  • Male
  • Maxilla* / surgery
  • Microsurgery / methods
  • Middle Aged
  • Perforator Flap* / blood supply
  • Perforator Flap* / transplantation
  • Plastic Surgery Procedures* / methods
  • Young Adult