What type of study is this?

This is a Human Clinical Trial study.

August 20, 2025

Reconstruction of Large Oromandibular Defects: A Single Chimeric Thoracodorsal Artery Flap With Scapula Versus Double Free Flaps

Key Points

The chimeric thoracodorsal artery flap group demonstrated reduced operation time and hospital costs compared to the double free flap group.
Significantly lower blood loss and hospital stay duration were observed with the chimeric flap approach.
Functional and aesthetic outcomes remained comparable between both reconstruction methods, ensuring reliability of the chimeric technique.
The incidence of complications was notably higher in the double free flap group, suggesting the chimeric flap may enhance patient safety.

Abstract

Background: Reconstructing extensive composite defects remains a significant challenge, as it requires a flap incorporating both bone and a substantial amount of soft tissue. This study introduces the chimeric thoracodorsal artery flap with the scapula and latissimus dorsi (cTDAF-SLD) as a viable and comprehensive option for reconstructing large oromandibular defects. Methods: Twenty-nine patients with mandibular-invading oral cancer underwent radical tumor resection, followed by oromandibular reconstruction using either a chimeric thoracodorsal artery flap with the scapula and latissimus dorsi (cTDAF-SLD, n=18) or a simultaneous combination of a fibular flap and an anterolateral thigh (ALT) flap (SCFAF, n=11). Perioperative variables were recorded and functional and aesthetic outcomes were assessed using the Visual Analogue Scale (VAS), the University of Washington Quality of Life (UW-QOL) questionnaire, and the water swallow test. Results: The cTDAF-SLD group exhibited significantly lower operation time, blood loss, hospital stay duration, drainage volume, and hospital costs compared with the SCFAF group ( P <0.05). No significant differences were observed between the 2 groups in terms of functional and aesthetic outcomes. However, the incidence of complications at both the recipient and donor sites was significantly higher in the SCFAF group than in the chimeric TDAF group ( P <0.05). Conclusions: The chimeric TDAF with the scapula is a reliable option for reconstructing extensive oromandibular defects, offering comparable functional and aesthetic outcomes to simultaneous double free flaps while reducing complications.

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