Hansen Scott L, Foster Robert D, Dosanjh Amarjit S, Mathes Stephen J, Hoffman William Y, Leon Pablo
San Francisco, Calif. From the Division of Plastic and Reconstructive Surgery, University of California, San Francisco.
Plast Reconstr Surg. 2007 Dec;120(7):1879-1884. doi: 10.1097/01.prs.0000287273.48145.bd.
Although free flap transfer is commonly performed to reconstruct defects of the upper two-thirds of the face and scalp, the superficial temporal artery and vein have historically not been considered adequate for microsurgical reconstruction and have rarely been described as recipient vessels. The purpose of this study was to determine the indications for and effectiveness of using the superficial temporal vessels for scalp and face reconstruction.
Retrospective chart review on all patients undergoing microsurgical reconstruction for defects of the upper two-thirds of the face between 1996 and 2003 revealed 45 free tissue transfers in which the superficial temporal artery and vein were considered for use as recipient vessels. Flap success rates and postoperative course were evaluated.
Forty-three patients underwent 45 free flap transfers. The superficial temporal artery was used as the recipient artery in every case. In three cases, the superficial temporal vein was not suitable as the recipient vein and required use of a vein in the neck. The median length of follow-up was 4 years. Flap survival was 96 percent. Five patients required reoperation for vascular compromise. One of these patients ultimately had flap failure. In that patient, a subsequent attempt at microvascular flap reconstruction was successful using the same superficial temporal artery and vein as recipient vessels.
Use of the superficial temporal artery and vein for scalp and face reconstruction is reliable and safe. The superficial temporal artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the upper two-thirds of the face and/or scalp.
尽管游离皮瓣移植常用于修复面部和头皮上三分之二的缺损，但颞浅动静脉在历史上一直被认为不足以用于显微外科重建，并且很少被描述为受区血管。本研究的目的是确定使用颞浅血管进行头皮和面部重建的适应症及有效性。
对1996年至2003年间所有接受显微外科修复面部上三分之二缺损的患者进行回顾性病历审查，发现45例游离组织移植中考虑使用颞浅动静脉作为受区血管。评估皮瓣成功率和术后病程。
43例患者接受了45次游离皮瓣移植。每例均使用颞浅动脉作为受区动脉。3例中，颞浅静脉不适合作为受区静脉，需要使用颈部静脉。中位随访时间为4年。皮瓣存活率为96%。5例患者因血管并发症需要再次手术。其中1例患者最终皮瓣失败。在该患者中，随后使用相同的颞浅动静脉作为受区血管进行微血管皮瓣重建获得成功。
使用颞浅动静脉进行头皮和面部重建可靠且安全。在面部和/或头皮上三分之二的显微外科重建中，颞浅动静脉应被视为主要的受区血管。
