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  • Title: Osteomyocutaneous peroneal artery-based combined flap for reconstruction of composite and en bloc mandibular defects.
    Author: Cheng MH, Saint-Cyr M, Ali RS, Chang KP, Hao SP, Wei FC.
    Journal: Head Neck; 2009 Mar; 31(3):361-70. PubMed ID: 19073007.
    Abstract:
    BACKGROUND: The osteomyocutaneous peroneal artery-based combined (OPAC) flap is a refinement of fibula osteoseptocutaneous flap, with the inclusion of partial soleus muscle based on an independent myocutaneous perforator. METHODS: Seventeen men underwent composite oromandibular reconstruction using an OPAC flap. Flaps were raised with 1 or 2 skin paddles and 2 to 3 bone segments. In 8 cases, a portion of soleus muscle was included. RESULTS: All flaps survived, but partial failure occurred in 2 cases (11.7%). At a mean follow-up of 25.3 +/- 19.4 months, 6 of 12 patients tolerated a regular diet, 5 a soft diet, and 1 a liquid diet. Speech was normal in 2 patients, intelligible in 4, and slurred in 6. CONCLUSION: Advantages of the OPAC flap include a single donor site, 1 pair of recipient vessels, versatile 3-dimensional inset, adequate soft tissue augmentation, and better aesthetic and functional outcomes.
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