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• W2225057862 abstract "The internal mammary artery perforator flap (IMAP) was described by Yu and co-workers for the reconstruction of tracheostoma and anterior neck. The utility of this flap rests in its ability to be used without microvascular anastomosis, its low bulk, and ability to be used in the vessel depleted neck. The IMAP was used in two cases of persistent pharyngocutaneous fistulas. Both patients were males with previous diagnosis of laryngeal squamous cell carcinoma who had failed organ preservation treatment with radiation. Following their laryngectomies, both patients developed pharyngocutaneous fistulaes that were not responsive to local pedicle flap reconstructions. One patient had a total of 13 reconstructive attempts at closure of the fistula including bilateral sternocleidomastoid muscle flaps, pectoralis muscle and delayed deltopectoral flap. All flaps had failed and he was subsequently referred for repair of two large fistulas. Preoperative evaluation revealed a strong Doppler pulse at the second and third intercostal spaces. He underwent repair of the fistula with a layered approach using turn in flap and an IMAP flap based on the second intercostals perforator. The other patient also presented with a fistula secondary to laryngectomy. In addition to the fistula he also had loss of the soft tissues over the carotid artery with a resultant exposure of the artery. He was subsequently reconstructed with an IMAP based on the third intercostals perforator. The IMAP flap is an important option to have in the reconstruction of anterior neck defects around trachea stoma. The flap is of particular importance in reconstruction of patients with vessel depleted necks where a thin flap is desired. The harvest of the IMAP flap is straight forward without the necessity of microvascular anastomosis." @default.
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• W2225057862 date "2009-05-01" @default.
• W2225057862 modified "2023-09-23" @default.
• W2225057862 title "Use of the internal mammary artery perforator flap for pharyngocutaneous fistulas in the vessel depleted neck" @default.
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• W2225057862 doi "https://doi.org/10.1016/j.ijom.2009.03.422" @default.
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