Parkes William J, Krein Howard, Heffelfinger Ryan, Curry Joseph
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut Street 6th Floor, Philadelphia, PA 19107, USA.
Plast Surg Int. 2011;2011:941742. doi: 10.1155/2011/941742. Epub 2011 Nov 10.
Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT) as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up. The ALT subset of the case series was the focus of the data reviewed for this paper. Selected cases were described to highlight some of the advantages of employing the ALT for cranio-orbitofacial reconstruction. Results. 51 free flaps in 47 patients were reviewed. 38 cases required orbital exenteration. The ALT was used in 33 patients. Complications included 1 hematoma, 2 wound infections, 3 CSF leaks, and 3 flap failures. Conclusions. Free tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The ALT provides a versatile option to reconstruct the many cranio-orbitofacial defects encountered.
目的。详细阐述一系列接受眼眶和眶周游离皮瓣重建术患者的临床结果，并强调股前外侧（ALT）皮瓣作为修复该区域缺损的主要手段。方法。对2006年9月至2011年5月期间47例行眼眶或眶周缺损游离皮瓣重建术的患者进行回顾性研究。回顾的数据包括人口统计学资料、缺损特征、使用的游离皮瓣、采用的其他重建技术、住院时间、并发症及随访情况。本病例系列中的ALT皮瓣亚组是本文回顾数据的重点。选取部分病例以突出使用ALT皮瓣进行颅眶面部重建的一些优势。结果。对47例患者的51个游离皮瓣进行了回顾。38例患者需要行眼眶内容物剜除术。33例患者使用了ALT皮瓣。并发症包括1例血肿、2例伤口感染、3例脑脊液漏和3例皮瓣坏死。结论。游离组织移植能够安全有效地修复眼眶及眶周结构的复杂缺损。重建方式的选择取决于软组织缺失范围、面中部骨质缺失情况及颅底受累情况。ALT皮瓣为修复多种颅眶面部缺损提供了一种通用的选择。
