The anatomical basis of the internal mammary vessel flap with anterior rib

Introduction: Anterior rib is suitable donor site for reconstruction of mandibular condyle. However, it was not used generally for small diameter and short length of intercostal vessel.

Aim: This study focused on the vascularized anterior rib graft suitable for reconstruction of condylar defect. And we also inspected the internal mammary vessel system as a vascular pedicle of this flap.

Material and method: Ten cadaveric dissections have been performed. We surveyed a pattern of intercostal vessel that was branched from internal mammary vessel and covering the 5th rib. And we also measured length, diameter, and location of vascular pedicle. In addition, we evaluated transverse thoracic muscle as a landmark of dissection.

Results: In dissection of ten cases, mean diameter of internal mammary vessel was as follows; Lt. artery: 2.45 mm, Lt. vein: 1.98 mm, Rt. artery: 2.64 mm, and Rt. vein: 2.98 mm. Its branching pattern was regular enough for classification of type. And transverse thoracic muscle was important landmark to avoid lung exposure in dissection.

Conclusion: Internal mammary vessel as a pedicle of the vascularized anterior rib showed constant anatomic structure and had large diameter enough for microanastomosis in maxillofacial reconstruction. Lung exposure in flap harvesting may be prevented effectively by guiding dissection plane with the aid of transverse thoracic muscle.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on The anatomical basis of the internal mammary vessel flap with anterior rib
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