Cranio-Maxillo-Facial Surgery Department 2, Plastic Surgery Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.
J Plast Reconstr Aesthet Surg. 2010 Jul;63(7):1110-6. doi: 10.1016/j.bjps.2009.06.009. Epub 2009 Jul 18.
Treatment of hemifacial atrophy presents a challenge for reconstructive surgeons. Previous studies have described numerous methods for the correction of facial asymmetry. We present our experience with treatment of hemifacial atrophy using a microsurgical anterolateral thigh adipofascial flap procedure and other adjunctive measures. This method is similar to that used for the free anterolateral thigh flap, but only the deep fascia of the anterolateral thigh and subcutaneous fatty tissue above the fascia were harvested. This flap procedure was used in 32 patients with moderate or severe hemifacial atrophy. In the first stage, the anterolateral thigh adipofascial flap procedure was used in all the patients, of whom eight accepted a porous polyethylene implant along with the anterolateral thigh adipofascial flap to reconstruct the skeleton. In the second stage, ancillary procedures including porous polyethylene implantation, liposuction debulking, fat injection and flap re-suspension were performed to refine the outcome in 28 patients. The anterolateral thigh adipofascial flap is advantageous in that it can provide a reliable vascular pedicle with relatively thin, pliable soft tissue and direct primary closure of the donor site.
治疗半侧颜面萎缩对重建外科医生来说是一个挑战。既往研究描述了许多用于矫正面部不对称的方法。我们介绍了使用显微外科股前外侧脂肪筋膜皮瓣手术和其他辅助措施治疗半侧颜面萎缩的经验。这种方法类似于游离股前外侧皮瓣的方法，但只采集股前外侧的深筋膜和筋膜上方的皮下脂肪组织。该皮瓣手术用于 32 例中重度半侧颜面萎缩患者。在第一阶段，所有患者均采用股前外侧脂肪筋膜皮瓣手术，其中 8 例接受多孔聚乙烯植入物联合股前外侧脂肪筋膜皮瓣以重建骨骼。在第二阶段，对 28 例患者进行了辅助手术，包括多孔聚乙烯植入、脂肪抽吸去脂、脂肪注射和皮瓣再悬吊，以改善治疗效果。股前外侧脂肪筋膜皮瓣的优点是可以提供可靠的血管蒂，其组织相对较薄，柔软，供区可直接一期闭合。
