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Canever et al: Evaluation of the superior and inferior labial musculomucosal flaps in cats: An angiographic study and case series
Veterinary Surgery 4, 2022

🔍 Key Findings

  • Superior and inferior labial arteries in cats perfuse robust angiosomes, which support musculomucosal axial pattern flaps.
  • Cadaver angiography confirmed vascular anatomy, with consistent patterns between sides and among specimens.
  • The vascular supply is located primarily in the musculomucosal layer, not the skin, critical for flap viability.
  • Flap harvest requires inclusion of the orbicularis oris (± buccinator) muscle to ensure vascular integrity and flap survival.
  • Two clinical cases demonstrated successful use of superior and inferior labial musculomucosal flaps for palatal reconstruction with complete flap survival and resolution of clinical signs.
  • Intraoperative transillumination aided vessel localization, facilitating surgical planning and flap design.
  • No cases of distal flap necrosis or dehiscence occurred, although mild donor site morbidity (lip retraction, mucosal denuding) was noted.
  • These flaps offer a valuable option when local tissues are compromised, especially after failed previous repairs or radiation therapy.

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← Articles

Canever et al: Evaluation of the superior and inferior labial musculomucosal flaps in cats: An angiographic study and case series
Veterinary Surgery 4, 2022

🔍 Key Findings

  • Superior and inferior labial arteries in cats perfuse robust angiosomes, which support musculomucosal axial pattern flaps.
  • Cadaver angiography confirmed vascular anatomy, with consistent patterns between sides and among specimens.
  • The vascular supply is located primarily in the musculomucosal layer, not the skin, critical for flap viability.
  • Flap harvest requires inclusion of the orbicularis oris (± buccinator) muscle to ensure vascular integrity and flap survival.
  • Two clinical cases demonstrated successful use of superior and inferior labial musculomucosal flaps for palatal reconstruction with complete flap survival and resolution of clinical signs.
  • Intraoperative transillumination aided vessel localization, facilitating surgical planning and flap design.
  • No cases of distal flap necrosis or dehiscence occurred, although mild donor site morbidity (lip retraction, mucosal denuding) was noted.
  • These flaps offer a valuable option when local tissues are compromised, especially after failed previous repairs or radiation therapy.

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Multiple Choice Questions on this study

In Canever 2022 et al., on labial flap vascular anatomy, which tissue layer was most critical to include to ensure arterial perfusion of the flap?

A. Epithelium only
B. Skin with orbicularis oris
C. Submucosa only
D. Musculomucosal layer including orbicularis oris
E. Mucoperiosteum

Answer: Musculomucosal layer including orbicularis oris

Explanation: The musculomucosal layer housed the key vascular network needed for flap survival.
In Canever 2022 et al., on labial flap vascular anatomy, what did angiographic evaluation of feline cadavers reveal about the blood supply to the upper and lower lips?

A. The vascular supply was primarily subcutaneous.
B. The musculomucosal layer lacked consistent arterial supply.
C. Each labium had a distinct angiosome supplied by either the superior or inferior labial artery.
D. Only the superior labial artery provided significant perfusion.
E. The facial artery did not contribute to lip vascularization.

Answer: Each labium had a distinct angiosome supplied by either the superior or inferior labial artery.

Explanation: Angiography confirmed robust angiosomes in the musculomucosal layer for both superior and inferior labial arteries.
In Canever 2022 et al., on labial flap vascular anatomy, which factor is considered most critical for survival of labial musculomucosal axial flaps?

A. Limited rotation arc
B. Firm mucoperiosteal bed
C. Including overlying skin
D. Preserving venous drainage
E. Including oral papillae

Answer: Preserving venous drainage

Explanation: Flap viability is especially dependent on adequate venous outflow, more so than arterial input.
In Canever 2022 et al., on labial flap vascular anatomy, which intraoperative technique was used to help locate labial vessels prior to flap design?

A. Doppler ultrasound
B. Fluoroscopy
C. CT angiography
D. Transillumination of the vestibular mucosa
E. Near-infrared imaging

Answer: Transillumination of the vestibular mucosa

Explanation: Transillumination was used to localize labial arteries and guide flap planning.
In Canever 2022 et al., on labial flap vascular anatomy, what postoperative complication occurred in Case 1 that required management?

A. Flap necrosis
B. Complete flap dehiscence
C. Dental trauma requiring extraction
D. Esophagostomy tube dislodgement
E. Abscess at the donor site

Answer: Esophagostomy tube dislodgement

Explanation: Case 1 experienced dislodgement of the esophagostomy tube but the flap healed fully.

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