Retroauricular lymph node flap: An anatomic and surgical feasibility study

BACKGROUND

The study investigated the anatomy of the retroauricular lymph node (LN) flap and evaluate its surgical feasibility as a new donor site for a free LN flap in lymphedema surgery.

METHODS

Twelve adult cadavers were examined. The course and perfusion of the anterior auricular artery (AAA) and the location and sizes of the retroauricular LNs were studied.

RESULTS

The AAA was available in 87% and absent in 13% specimens. The AAA's origin had a mean vertical distance of 12.2 ± 6.9 mm and a mean horizontal distance of 19.1 ± 4.2 mm from the superior attachment of the ear. The mean diameter of the AAA was 0.8 ± 0.2 mm. The mean number of LN per region was 7.7 ± 2.3, with an average LN size of 4.1 ± 1.9 × 3.2 ± 1.7 mm. The LN were categorized into anterior (G1) and posterior (G2) groups, with a total of 59 and 10 LN, respectively. In a cluster analysis, three LN clusters could be detected across the anterior group (G1).

CONCLUSIONS

The retroauricular LN flap is a delicate but feasible flap with reliable anatomy, containing a mean of 7.7 LNs.

[Advances on anatomic study and clinical application of submental artery island flap]

After more than 20 years of development, submental artery island flap (SMAIF) has become a versatile flap for head and neck reconstruction of the defects after tumor resection,trauma or facial deformity.The design of SMAIF is flexible and diverse. According to repair requirements,various types of flap can be harvested based on the different composition. SMAIF mainly used as an orthograde pedicled flap.It also can be used as a retrograde, free or hybrid variant.More modifications such as bipaddled, bipedicled, pre-expanded,deepithelialized were evolved. SMAIF shows some advantages including reliable blood supply, convenient preparation, well matched color with the facial skin, and the similar or even better repair effect compared with free flaps.In addition,the submental artery perforator flap and the submental vascularized lymph node flap are the latest clinical application achievements derived from the progress of anatomic research.They further improve the level of preparation skill and expand the indications of SMAIF.