Seattle, Wash. From the Division of Plastic Surgery, University of Washington.
Plast Reconstr Surg. 2013 Feb;131(2):260e-269e. doi: 10.1097/PRS.0b013e3182778938.
After reading this article, the participant should be able to: 1. Discuss the principles behind the choice of reconstructive techniques for all major head and neck regions. 2. Differentiate between the optimal choices for reconstruction of the different mandibulectomy defects. 3. List the requirements for successful reconstruction of the skull base. 4. Further study new and evolving head and neck reconstruction techniques and options.
Management of head and neck cancer has undergone many significant changes during the past two decades. This article gives an overview of the major areas in the head and neck, highlighting current practice and more recent trends in reconstruction choices. Further detail is given in the related videos. The five attached videos depict individual techniques of mandibular reconstruction, showing the technique of fibular dissection and osteotomy: endoscopic skull base reconstruction through a transpterygoid/lateral canthotomy approach, scalp reconstruction using a latissimus dorsi free flap and skin graft, maxillary reconstruction using the deep circumflex iliac artery iliac crest and internal oblique flap, and pharyngoesophageal reconstruction using an anterolateral thigh flap.
阅读本文后,学员应能够:1. 讨论所有主要头颈部区域重建技术背后的原则。2. 区分不同下颌骨切除术缺陷的最佳重建选择。3. 列出成功重建颅底的要求。4. 进一步研究新的和不断发展的头颈部重建技术和选择。
在过去的二十年中,头颈部癌症的治疗发生了许多重大变化。本文概述了头颈部的主要领域,重点介绍了当前的实践和最近在重建选择方面的趋势。相关视频中提供了更详细的信息。这五个附加视频描述了下颌骨重建的个别技术,展示了腓骨解剖和截骨术:经翼突/外侧眦切开入路的内镜颅底重建、使用背阔肌游离皮瓣和植皮的头皮重建、使用旋髂深动脉髂嵴和内斜肌瓣的上颌骨重建,以及使用前外侧大腿皮瓣的咽食管重建。