Huber Katherine Marie, Boyd Travis Guthrie, Quillo Amy R, Wilhelmi Bradon J
Eplasty. 2012;12:e44. Epub 2012 Sep 10.
Many case reports have described anatomical variants of the pectoralis muscles. However, there is a paucity of published literature on the consequence of such presentations in reconstructive breast surgery.
A 45-year-old female patient with breast cancer presented for left mastectomy and immediate reconstruction with tissue expander. During mastectomy, she was noted to have an extra muscle anterior to her pectoralis major muscle. This variant had not previously been described in the literature and was therefore named the oblique pectoralis anterior. After inspection of the aberrant musculature, the decision was made to release the inferolateral insertion of the accessory muscle with the inferior edge of pectoralis major. An adequate pocket for the expander was created.
After routine expansion and implant exchange, muscular coverage of the implant from pectoralis major and the oblique pectoralis anterior muscle approximated 70%. The patient was left with good symmetry and a cosmetic result, despite the challenges presented by her anomalous chest wall musculature.
Prior knowledge of the various anatomic aberrations described in the literature can prepare a surgeon to properly incorporate and utilize the variant anatomy, should it be encountered, to benefit the outcome of the operation.
许多病例报告描述了胸肌的解剖变异。然而，关于此类表现形式在乳房重建手术中的后果，发表的文献较少。
一名45岁的乳腺癌女性患者前来接受左侧乳房切除术并立即使用组织扩张器进行重建。在乳房切除术中，发现她的胸大肌前方有一块额外的肌肉。这种变异此前在文献中未曾描述，因此被命名为前斜胸肌。在检查异常肌肉组织后，决定将副肌的下外侧附着点与胸大肌的下缘分离。为扩张器创建了一个合适的腔隙。
经过常规扩张和植入物置换后，胸大肌和前斜胸肌对植入物的肌肉覆盖约为70%。尽管患者胸壁肌肉结构异常带来了挑战，但她仍保持了良好的对称性和美观效果。
了解文献中描述的各种解剖变异，可使外科医生在遇到变异解剖结构时做好准备，以便正确整合和利用它，从而提高手术效果。
