J Korean Cleft Palate-Craniofac Assoc.  2009 Apr;10(1):44-48.

Reconstruction of the Face Using Thoracodorsal Artery Perforator Free Flap after Resection of Arteriovenous Malformation

• Park BJ
• Lim SY
• Pyon JK
• Mun GH
• Bang SI
• Oh KS

Abstract

PURPOSE: The treatment of arteriovenous malformation (AVM) of the face remains a difficult challenge in plastic surgery. Incomplete resection resulting in uncontrolled bleeding, postoperative enlargement of the remaining malformation, and a poor functional and cosmetic result could be the problems confronted by the surgeons.
METHODS
A 37 year-old male with large arteriovenous malformation in face treated with preoperative superselective transarterial embolization and free flap transfer. The size of the defect was 13 x 9 cm. Sclerotheraphy without resection were performed several times but the results were unsatisfactory. Resection was performed the next day of embolization. We were able to repair with the thoracodorsal artery perforator free flap. And facial muscle reconstruction performed by simultaneous muscle and nerve transfer.
RESULTS
During the follow-up period 8 months the patient regained an acceptable cosmetic appearance. And he has shown no reexpansion of the malformation.
CONCLUSION
The thoracodorsal artery perforator free flap could be a good choice for the reconstruction for massive defects of the face. A huge arteriovenous malformation could be safely removed and successfully reconstructed by the complete embolization, wide excision and coverage with a well vascularized tissue.

Keyword

Arteriovenous malformation; Thoracodorsal artery perforator free flap

MeSH Terms

Arteries
Arteriovenous Malformations
Cosmetics
Facial Muscles
Follow-Up Studies
Free Tissue Flaps
Hemorrhage
Humans
Male
Muscles
Nerve Transfer
Surgery, Plastic
Cosmetics