Design and application of the superior thyroid artery perforator flap
10.3760/cma.j.cn115330-20250313-00148
- VernacularTitle:甲状腺上动脉穿支皮瓣的设计与应用
- Author:
Lei OUYANG
1
;
Hang LING
1
;
Zijia WANG
1
;
Pengxin HUANG
1
;
Haolei TAN
1
;
Jinyun LI
1
;
Wenxiao HUANG
1
;
Jie CHEN
1
;
Pingqing TAN
1
;
Hailin ZHANG
1
Author Information
1. 湖南省肿瘤医院 中南大学湘雅医学院附属肿瘤医院头颈外科，长沙 410013
- Publication Type:Journal Article
- Keywords:
Head and neck neoplasms;
Superior thyroid artery perforator flap;
Perforator flap;
Defect reconstruction;
Venous retrograde drainage
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(9):1172-1176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the design and application of the superior thyroid artery perforator flap (STAPF) for reconstruction after head and neck oncological resection.Methods:A retrospective analysis was performed on 24 consecutive patients (22 men, 2 women; age 40-72 years) treated at Hunan Cancer Hospital between June 2018 and December 2023. Their primary tumors included buccal carcinoma ( n=7), tongue carcinoma ( n=8), oropharyngeal carcinoma ( n=2), floor-of-mouth carcinoma ( n=3), laryngeal carcinoma ( n=3), and hypopharyngeal carcinoma ( n=1). Flap design, venous drainage strategy, and postoperative outcomes were assessed. SPSS 19.0 software was used for statistical analysis. Results:Flap dimensions were length of 9.4±0.5 cm, width of 3.3±0.6 cm, thickness of 0.5±0.2 cm, and pedicle length of 7.3±0.6 cm. Fifteen flaps were based on a single perforator (diameter ≥0.5 mm), whereas, nine fascial flaps incorporated multiple perforators (capillary diameter ≤0.5 mm). Venous drainage routes were as follows: superior thyroid vein ( n=12, retrograde in 3), facial vein ( n=5, all retrograde), anterior jugular vein ( n=4, retrograde in 1), and external jugular vein ( n=3, retrograde in 2). All 24 flaps survived completely. Donor sites were closed primarily and all cervical wounds healed. No flap-related complications, inculding orocutaneous, pharyngocutaneous, laryngocutaneous fistula and wound infection, were observed. Final pathologic stages were T1N0M0 ( n=2), T2N0M0 ( n=16), T2N1M0 ( n=3), and T3N0M0 ( n=3). With follow-up of 12-46 months, aside from one patient with tongue cancer died of contralateral cervical and parapharyngeal lymph-node metastases at 6 months, others remained disease-free. Patients with laryngeal or hypopharyngeal carcinoma had their tracheostomy tubes removed within 4 weeks postoperatively. Conclusion:STAPF offers flexible design, with minimal donor-site morbidity and low functional impairment. It is particularly advantageous for reconstruction of small-to-moderate defects following head and neck tumor ablation.
