Takushima Akihiko, Harii Kiyonori, Asato Hirotaka, Momosawa Akira, Okazaki Mutsumi
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka-shi, 181-8611, Japan.
J Plast Reconstr Aesthet Surg. 2006;59(5):465-73. doi: 10.1016/j.bjps.2005.10.011.
Neurovascular free muscle transfer is now the mainstay for smile reconstruction in the treatment of established facial paralysis. Since facial paralysis due to ablative surgery or some specific disease sometimes accompanies defects of the facial skin and soft tissue, simultaneous reconstruction of defective tissues with facial reanimation is required. The present paper reports results for 16 patients who underwent reconstruction by simultaneous soft tissue flap transfer with latissimus dorsi muscle for smile reconstruction of the paralysed face. Soft tissue flaps comprised skin paddle overlying the latissimus dorsi muscle (n=6), serratus anterior musculocutaneous flap (n=5), serratus anterior muscle flap (n=2), and latissimus dorsi perforator-based flap with a small muscle cuff (n=3). The latissimus dorsi muscle can be elevated as a compound flap of various types, and thus offers the best option as a donor muscle for facial reanimation when soft tissue defects require simultaneous reconstruction.
神经血管游离肌肉移植目前是治疗晚期面瘫时微笑重建的主要方法。由于切除性手术或某些特定疾病导致的面瘫有时会伴有面部皮肤和软组织缺损，因此需要在进行面部功能重建的同时对缺损组织进行修复。本文报告了16例患者的治疗结果，这些患者通过背阔肌软组织瓣转移同时进行瘫痪面部的微笑重建。软组织瓣包括覆盖背阔肌的皮瓣（n = 6）、前锯肌肌皮瓣（n = 5）、前锯肌肌瓣（n = 2）和带小肌肉袖套的背阔肌穿支皮瓣（n = 3）。背阔肌可作为多种类型的复合瓣提起，因此当软组织缺损需要同时修复时，它是面部功能重建的最佳供肌选择。
