Philadelphia, Pa. From the Hospital of the University of Pennsylvania.
Plast Reconstr Surg. 2013 Mar;131(3):537-543. doi: 10.1097/PRS.0b013e31827c6eba.
Composite facial allografts have become increasingly popular in the reconstruction of complex facial defects. Good to excellent aesthetic results can be achieved, particularly when a foundation of donor skeleton has been transferred. The authors propose using a conventional craniofacial technique (monobloc osteotomy) to transfer a thin monocortical foundation of bone, even in lieu of a skeletal defect, to improve the recipient periorbital and malar aesthetics.
The monobloc osteotomy approach was used to obtain a full facial allograft and modified ex vivo to a thin monocortical layer and transferred to an anatomical facial skeleton. The authors have named this the "masque" flap because of the resemblance of the outline of the foundation of bone to a costume worn in masquerade balls.
The masque flap was performed on two fresh-frozen cadavers. The total time to harvest and thin the osteomyocutaneous flap was 155 minutes (30 minutes to modify it ex vivo). The average total surface area was 1060 cm. Periorbital and malar ligaments were maintained, as was the integrity of the canthal tendons.
The modified monobloc composite facial allograft technique allows transfer of a full facial allograft and maintains malar projection and excellent shape of the palpebral aperture.
复合面部同种异体移植物在复杂面部缺损的重建中越来越受欢迎。当转移供体骨骼基础时，可以实现良好到优秀的美学效果。作者提出使用传统的颅面技术（整块骨切开术）来转移薄的单层皮质骨基础，即使在没有骨骼缺损的情况下，也可以改善受区眶周和颧骨美学。
采用整块骨切开术获得全面部同种异体移植物，并对其进行改良，制成薄的单层皮质骨层，并转移到解剖面部骨骼上。作者将这种方法命名为“面具”皮瓣，因为骨基础的轮廓类似于假面舞会中所戴的面具。
两名新鲜冷冻尸体上进行了面具皮瓣手术。采集和变薄骨肌皮瓣的总时间为 155 分钟（体外修改 30 分钟）。平均总表面积为 1060 平方厘米。维持了眶周和颧骨韧带以及内眦肌腱的完整性。
改良的整块复合面部同种异体移植物技术允许全面部同种异体移植物的转移，并维持颧骨突出和睑裂的良好形状。
