1.Effectiveness of innervated medial plantar flap for reconstruction of soft tissue defects following foot tumor resection.
Wenchao ZHANG ; Luqi GUO ; Yan HAO ; Liangya WANG ; Chao ZHANG ; Yun WANG ; Jiuzuo HUANG ; Ang ZENG ; Xiao LONG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1086-1090
OBJECTIVE:
To evaluate the effectiveness of the innervated medial plantar flap for reconstructing soft tissue defects, particularly in the weight-bearing zone, after resection of foot tumors.
METHODS:
A retrospective analysis was conducted on 12 patients with malignant skin and soft tissue tumors of the foot treated between October 2023 and December 2024. The cohort included 8 males and 4 females, aged 42-67 years (mean, 57.5 years). Tumor types comprised malignant melanoma (5 cases), squamous cell carcinoma (4 cases), arsenical keratosis (2 cases), and tumor-induced osteomalacia (1 case). Soft tissue defects located in the heel weight-bearing region in 10 cases and non-weight-bearing ankle region in 2 cases, with defect sizes ranging from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm. Preoperative photon-counting CT angiography (PC-CTA) was performed to assess the medial plantar artery and its perforators. All patients underwent radical tumor resection with confirmed negative margins. The resulting defects were reconstructed using a innervated medial plantar flap incorporating sensory branches of the medial plantar nerve. The flap donor site was covered with a split-thickness skin graft harvested from the ipsilateral inguinal region.
RESULTS:
The operation was successfully completed in all 12 patients. All flaps survived completely without vascular compromise, partial necrosis, or total loss. Incisions healed primarily without dehiscence or infection. Minor skin graft necrosis occurred at the donor site in 3 patients, which healed within 2-3 weeks with routine dressing changes. No donor site complication (e.g., tendon or nerve injury) occurred. Patients were followed up 2-16 months (mean, 10.3 months). At last follow-up, there was no tumor recurrence. Flaps exhibited good color and texture match with surrounding tissue, restored sensation, and all feet achieved normal weight-bearing activity.
CONCLUSION
The innervated medial plantar flap, precisely designed based on PC-CTA localization, provides reliable blood supply and effective sensory restoration. It is an ideal method for reconstructing soft tissue defects after foot tumor resection, especially in the heel weight-bearing region.
Humans
;
Male
;
Middle Aged
;
Female
;
Plastic Surgery Procedures/methods*
;
Adult
;
Aged
;
Retrospective Studies
;
Soft Tissue Neoplasms/surgery*
;
Surgical Flaps/blood supply*
;
Foot/surgery*
;
Skin Neoplasms/surgery*
;
Soft Tissue Injuries/surgery*
;
Carcinoma, Squamous Cell/surgery*
;
Treatment Outcome
;
Skin Transplantation/methods*
;
Melanoma/surgery*
2.The clinical outcomes of using superficial circumflex iliac artery perforator flap and radial forearm free flap for reconstructing oral and maxillofacial soft tissue defects.
Changquan WANG ; Tianbin HUANG ; Shanbin GUAN ; Guangru HUANG ; Xiaoyuan CHENG ; Liushan LU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(6):534-541
Objective:To compare the clinical outcomes of reconstruction of oral and maxillofacial soft tissue defects using superficial circumflex iliac artery perforator flap (SCIA PF) and radial forearm free flap (RFF). Methods:A retrospective analysis was conducted on 90 patients with head, neck, and maxillofacial tumors who were treated in our department from June 2019 to January 2024. Patients were divided into two groups based on the surgical method used: the SCIA group(n=45), who underwent reconstruction with SCIA PF, and the RFF group(n=45), who received RFF reconstruction. Six months postoperatively, clinical efficacy was evaluated by comparing flap swelling, flap survival rate, and patient satisfaction. Oral function was assessed using standardized scoring systems before surgery, at 1 week, 3 months, and 6 months post-surgery. Hemorheological parameters, including high-shear viscosity(shear rate 200/s), low-shear viscosity(shear rate 30/s), plasma viscosity, erythrocyte aggregation index, and erythrocyte sedimentation rate(ESR), were also measured at each time point. Results:Compared with the RFF group, the SCIA group showed significantly larger flap size, longer flap harvesting and reconstruction times, earlier nasogastric tube removal and oral intake initiation, higher scores in all aspects of oral function, reduced flap edema and faster resolution, higher flap survival rates, and greater overall satisfaction (all P<0.05). During the follow-up period (preoperative, 1 week, 3 months, and 6 months post-surgery), hemorheological indices including high-and low-shear viscosity, plasma viscosity, erythrocyte aggregation index, and ESR progressively decreased in the SCIA group (P<0.05). In the RFF group, these parameters improved significantly by 6 months postoperatively compared with preoperatively and 1-week postoperatively, with a notable decrease in erythrocyte aggregation index at 6 months (P<0.05). Conclusion:Compared with RFF, SCIA PF provides larger flaps, better functional recovery, higher patient satisfaction, improved flap survival, fewer complications, and more favorable hemorheological profiles following reconstructive surgery for oral and maxillofacial defects.
Humans
;
Perforator Flap/blood supply*
;
Plastic Surgery Procedures/methods*
;
Retrospective Studies
;
Free Tissue Flaps
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Iliac Artery/transplantation*
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Forearm/surgery*
;
Male
;
Female
;
Soft Tissue Injuries/surgery*
;
Head and Neck Neoplasms/surgery*
;
Middle Aged
;
Treatment Outcome
;
Adult
4.Efficacy and safety of Anlotinib in the treatment of advanced sarcoma.
Qiang YAN ; Wei Tao YAO ; Xin Hui DU ; Liang Yu GUO ; Yi Chao FAN
Chinese Journal of Oncology 2023;45(10):904-910
Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.
Humans
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Hand-Foot Syndrome
;
Retrospective Studies
;
Sarcoma/drug therapy*
;
Sarcoma, Synovial/drug therapy*
;
Soft Tissue Neoplasms
;
Bone Neoplasms
5.Application of bilateral facial perforator artery flap in repairing large area defect in middle and lower part of nose.
Qinghua XU ; Haoran LI ; Xiao HE ; Jie CAI ; Hong WANG ; Juhui ZHAO ; Liliang ZHAO ; Xiaofeng ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(10):1266-1269
OBJECTIVE:
To investigate the feasibility and effectiveness of bilateral facial perforator artery flap in repairing large area defect in middle and lower part of nose.
METHODS:
The clinical data of 18 patients with large area defect in middle and lower part of nose repaired by bilateral facial perforator artery flap between January 2019 and December 2022 were retrospectively analyzed. Among them, there were 13 males and 5 females, the age ranged from 43 to 81 years, with an average of 63 years. There were 3 cases of nasal trauma, 4 cases of basal cell carcinoma, 8 cases of squamous cell carcinoma, 1 case of lymphoma, and 2 cases of large area solar keratosis. The size of the defect ranged from 3.0 cm×3.0 cm to 4.5 cm×4.0 cm; the size of unilateral flap ranged from 3.0 cm×1.3 cm to 3.5 cm×2.0 cm, and the size of bilateral flaps ranged from 3.3 cm×2.6 cm to 4.5 cm×4.0 cm.
RESULTS:
One patient developed skin flap necrosis after operation, and a frontal skin flap was used to repair the wound; 1 case gradually improved after removing some sutures due to venous congestion in the skin flap, and the wound healing was delayed after dressing change; the remaining 16 cases of bilateral facial perforator artery flaps survived well and all wounds healed by first intention, without any "cat ear" malformation. All 18 patients had first intention healing in the donor area, leaving linear scars without obvious scar hyperplasia, and no facial organ displacement. All patients were followed up 3-12 months, with an average of 6 months. Due to the appropriate thickness of the flap, none of the 18 patients underwent secondary flap thinning surgery. All flaps had good blood circulation, similar texture and color to surrounding tissues, symmetrical bilateral nasolabial sulcus, and high patient satisfaction.
CONCLUSION
The bilateral facial perforator artery flaps for repairing large area defect in middle and lower part of nose can achieve good appearance and function, and the operation is relatively simple, with high patient satisfaction.
Male
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Female
;
Humans
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Adult
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Plastic Surgery Procedures
;
Skin Transplantation
;
Retrospective Studies
;
Soft Tissue Injuries/surgery*
;
Perforator Flap/blood supply*
;
Arteries/surgery*
;
Cicatrix/surgery*
;
Treatment Outcome
;
Skin Neoplasms/surgery*
6.Advances in the treatment of infantile hemangiomas of the larynx.
Xing GAO ; Xiaojun ZHAN ; Qinglong GU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):972-976
Infantile hemangiomas are relatively common soft tissue tumors in infants and young children, with a prevalence of about 4.5% in full-term newborns. Subglottic Hemangioma (SGH) is a relatively rare type of hemangioma, and its special location often causes respiratory distress and potentially life-threatening conditions in infants. Therefore, it is necessary for clinicians to make an accurate diagnosis and formulate a detailed treatment plan based on the clinical manifestations, the auxiliary examinations, the medical history and the vital signs evaluation of patients.This review describes the pathophysiological mechanism of infantile hemangioma and provides a detailed discussion on commonly used treatment methods in detail.
Child, Preschool
;
Humans
;
Infant
;
Infant, Newborn
;
Hemangioma/diagnosis*
;
Hemangioma, Capillary
;
Laryngeal Neoplasms/surgery*
;
Larynx/pathology*
;
Soft Tissue Neoplasms
7.A case report of nasopharyngeal inflammatory myofibroblastoma in infant.
Chao CHENG ; Jianwen ZHONG ; Shuncheng WANG ; Dabo LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):989-992
Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
Humans
;
Infant
;
Granuloma, Plasma Cell/pathology*
;
Nasopharynx/pathology*
;
Neoplasms, Muscle Tissue
;
Soft Tissue Neoplasms
8.Clinical analysis of diversity of defect repair with supraclavicular island flap after head and neck tumor surgery.
Yue GUAN ; Guohua HU ; Zhihai WANG ; Wei MA ; Xiaoqiang WANG ; Min PAN ; Jiang ZHU ; Quan ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):1005-1010
Objective:To investigate the diversity and clinical effect of supraclavicular island flap in repairing the defect after head and neck tumor surgery. Methods:A retrospective analysis was performed on 30 patients who received the repair of head and neck defects with supraclavicular island flaps at Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Chongqing Medical University from January 2017 to March 2023. The sites and types of defects, intraoperative blood loss, time of flaps preparation, areas of flaps, survival of the flaps and other complications were recorded. Results:A total of 30 patients were enrolled, including 26 males and 4 females, aged 36-82 years. Among them, 22 patients with hypopharyngeal partial defect were repaired (19 patients with ipsilateral defect and 3 patients with contralateral defect). In addition, 2 patients were repaired with contralateral pectoralis major musculocutaneous flap around the hypopharynx, the neck skin defect was repaired in 2 patients, the parotid skin defect was repaired in 2 patients, the temporal bone skin defect was repaired in 1 patient, and the cervical esophageal defect was repaired in 1 patient. The average blood loss during the operation was 8 ml, and the average time was 32 min. The flap areas ranged from 5.0 cm×4.0 cm to 20.0 cm×8.0 cm. 27 of 30 flaps survived(90.0%), and pharyngeal fistula occurred in 6 patients after operation(4 flaps survived after local dressing). One patient was complicated with venous thrombosis(the flap necrosis after local dressing). Shoulder and neck functions(lift, internal rotation and abduction) were not significantly affected in 29 patients, and the function of 1 patient with shoulder infection was not affected after treatment. Conclusion:Supraclavicular island flap is a highly vascularized axial fascial flap. It is easy to make, thin, and soft in texture, and can be used to repair different sites and types of postoperative head and neck tumor defects with a low donor site complication rate. Good results in post-operative repair of head and neck tumors are worth promoting.
Male
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Female
;
Humans
;
Plastic Surgery Procedures
;
Retrospective Studies
;
Skin Transplantation
;
Soft Tissue Injuries/surgery*
;
Treatment Outcome
;
Surgical Flaps
;
Head and Neck Neoplasms/surgery*
9.Clinical and imaging features of phosphaturic mesenchymal tumors.
Cheng CHANG ; Aihong YU ; Yuhua YOU ; Xiaoxin PENG ; Xiaoguang CHENG ; Xintong LI ; Wei LIANG ; Lihua GONG ; Wei DENG
Chinese Medical Journal 2023;136(3):351-353

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