颞肌筋膜瓣重建颅中窝底后使用钛网重建以维持头皮轮廓：技术要点及两例报告
Titanium mesh reconstruction to maintain scalp contour after temporalis musculofascial flap reconstruction of the floor of the middle cranial fossa: a technical note and report of two cases.
作者信息
Lipira Angelo, Limbrick David, Haughey Bruce, Custer Phillip, Chicoine Michael R
机构信息
Departments of Neurosurgery, Otolaryngology and Ophthalmology, The Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital, Saint Louis, Missouri.
出版信息
Skull Base. 2009 Jul;19(4):303-9. doi: 10.1055/s-0028-1114300.
OBJECTIVE
Temporalis musculofascial rotational flaps can provide excellent tissue for reconstruction of defects in the floor of the middle cranial fossa. This technique can, however, result in cosmetic deformity of the temporal fossa with an asymmetric contour of the head. We report a technique that uses titanium mesh and autologous abdominal adipose to maintain a normal scalp contour.
CLINICAL PRESENTATION
Two patients, one with a large middle cranial fossa and infratemporal schwannoma, and another with penetrating trauma secondary to a rifle accident, required surgical repair of defects of the floor of the middle cranial fossa.
INTERVENTION
The repair was achieved in both cases using a temporalis musculofascial rotational flap. Normal contour of the scalp was maintained with titanium mesh and autologous abdominal adipose reconstruction.
CONCLUSION
The temporalis musculofascial flap, combined with titanium mesh and autologous adipose reconstruction, provided excellent closure of defects of the floor of the middle cranial fossa while preserving normal cosmetic scalp contour.
目的
颞肌筋膜旋转皮瓣可为颅中窝底缺损的修复提供优质组织。然而，该技术可能导致颞窝出现美容畸形，使头部轮廓不对称。我们报告一种使用钛网和自体腹部脂肪来维持正常头皮轮廓的技术。
临床表现
两名患者，一名患有大型颅中窝和颞下神经鞘瘤，另一名因步枪意外导致穿透性创伤，均需要对颅中窝底缺损进行手术修复。
干预措施
两例均采用颞肌筋膜旋转皮瓣进行修复。通过钛网和自体腹部脂肪重建维持了头皮的正常轮廓。
结论
颞肌筋膜瓣联合钛网和自体脂肪重建，能出色地闭合颅中窝底缺损，同时保留正常的头皮美容轮廓。
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