Department of Cranio-Maxillofacial and Plastic Facial Surgery, J. W. Goethe-University of Frankfurt Medical Centre, Frankfurt, Germany.
Microsurgery. 2014 Mar;34(3):229-32. doi: 10.1002/micr.22200. Epub 2013 Oct 31.
In this report, we present a case of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate with transoral single arterial and three venous anastomoses. A 17-years-old female patient presented a large cleft palate defect and complete dentition, dysmelia of both arms and bilateral thumb aplasia. A radial flap was prelaminated using oral mucosa 5 days prior to transplantation. Five days after flap prelamination, the facial artery and vein, submandibular vein, and a venous branch to the masseter muscle behind the buccinator muscle fibers were exposed through an intraoral incision lateral to the inferior right mucogingival junction. The radial artery, its bilateral accompanying veins, and the cephalic vein of transplanted flap were anastomosed transorally to the facial vessels, submandibular vein, and masseter branch. The vessel pedicle ran through the palatoglossal arch dorsal to the second upper molar. Good flow and flap perfusion were evinced, and further-on successful healing was achieved. The case encourages similar treatment in comparable situations avoiding facial nerve hazard and extraoral scars.
在本报告中，我们介绍了一例经口腔单动脉和三静脉吻合的预制前臂桡侧皮瓣在重建大面积持续性腭裂中的应用。一名 17 岁女性患者表现为大面积腭裂缺损和完全牙列、双侧上肢畸形和双侧拇指缺如。在移植前 5 天，使用口腔黏膜预制桡侧皮瓣。预制桡侧皮瓣 5 天后，通过位于右下唇龈黏膜交界线下侧的口腔内切口暴露面动脉和面静脉、下颌下静脉以及位于颊肌纤维后的咬肌静脉分支。经口腔将桡动脉及其双侧伴行静脉和移植皮瓣的头静脉吻合到面血管、下颌下静脉和咬肌分支。血管蒂穿过第二磨牙上方的腭舌弓。显示出良好的血流和皮瓣灌注，进一步成功实现了愈合。该病例鼓励在类似情况下采用类似的治疗方法，避免面神经损伤和面部瘢痕。
