Tulane School of Medicine, Division of Plastic Surgery, New Orleans, LA 70112, USA.
J Plast Reconstr Aesthet Surg. 2010 Aug;63(8):e615-8. doi: 10.1016/j.bjps.2010.01.027. Epub 2010 Feb 18.
Reconstruction following oncologic resection in the head and neck is complex due to large surgical defects left after removal of skin, subcutaneous, and skeletal structures. It is essential to adequately fill the defect as well as provide an acceptable tissue match in terms of tone, texture, thickness and contour. A 55-year-old male presented with an advanced melanoma in the right pre-tragal area. Surgical resection was performed including a total auriculectomy. A tunnelled right supraclavicular artery island (SAI) flap was used to repair the surgical defect. A Doppler probe ensured adequate circulation within the flap, especially in the distal tip. Reconstruction using the SAI flap after oncologic ear resection reduced operating room time, required less technical expertise, and provided excellent tissue match compared to more traditional methods of surgical defect reconstruction including free flaps, local flaps, and pedicled myocutaneous flaps. Successful use of the SAI flap in this case further expands the flaps versatility. We recommend that the reconstructive surgeon consider the SAI flap when presented with challenging infratemporal fossa and lateral skull base cases.
由于头颈部皮肤、皮下组织和骨骼结构切除后会留下较大的手术缺损，因此肿瘤切除后的重建较为复杂。充分填补缺损并在色调、质地、厚度和轮廓方面提供可接受的组织匹配至关重要。一位 55 岁男性，右侧耳前区患有晚期黑色素瘤。手术切除包括全耳切除术。使用隧道式右锁骨下动脉岛状（SAI）皮瓣修复手术缺损。多普勒探头确保皮瓣内有足够的循环，尤其是在远端尖端。与游离皮瓣、局部皮瓣和带蒂肌皮瓣等更传统的手术缺损重建方法相比，SAI 皮瓣用于肿瘤切除后的重建可减少手术室时间，对技术专长的要求更低，并提供更好的组织匹配。在这种情况下成功使用 SAI 皮瓣进一步扩展了皮瓣的多功能性。我们建议当遇到具有挑战性的颞下窝和外侧颅底病例时，重建外科医生应考虑 SAI 皮瓣。
