Anatomic Research And Clinical Application Of Expended Facial Artery Perforator Flaps With Cervical Small Perforators

Objective To explore the anatomy of expended facial artery perforator flaps with cervical small perforators and the clinical application for extensive facial defects with these flaps.Methods Necks of fresh cadavers were dissected for studying the anatomy basis of expended facial artery perforator flaps with cervical small perforators.The small perforators derived from facial artery were recognized and number,diameter,route of these vessels were recorded.Based on the anatomy basis,two-stage operation was performed.In the first stage,expander was embedded above the platysma and the pedicle,cervical small facial artery perforator,was reserved.After two weeks,in the second stage,the expended perforator flap was transferred as propeller flap,advanced flap or tunnel flap to reconstruct extensive facial defects.Results Cadavers dissection research revealed 3 or 4 perforators were out from facial artery when it crossed marginal mandibular and vertically penetrated platysma to the superficial fascia layer to supply cervical skin.The perforators from the origin at the facial artery to the skin,ranged from 12 to 30mm(average,19mm).The diameters of the facial artery perforators at the level of origin of the facial artery ranged from 0.3 to 1.6mm(average,1.1mm).In clinic,all flaps presented with satisfactory functional and aesthetic outcomes.Conclusions This design of expended facial artery perforator flaps with cervical small perforators provide an excellent method for reconstruction of extensive facial defects.