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颞顶筋膜瓣在各种临床场景中的应用:71例病例回顾。

The use of the temporoparietal fascia flap in various clinical scenarios: A review of 71 cases.

作者信息

Mokal Nitin J, Ghalme Amol N, Kothari Deepak S, Desai Mahinoor

机构信息

Deparment of Plastic Surgery, G.T Hospital, Mumbai, Maharashtra, India.

Deparment of Plastic Surgery, J.J Hospital, Mumbai, Maharashtra, India.

出版信息

Indian J Plast Surg. 2013 Sep;46(3):493-501. doi: 10.4103/0970-0358.121988.

Abstract

OBJECTIVE

This report details our experience with the use of the temporoparietal fascia flap in different scenarios of reconstruction and to discuss our technique of harvest, clinical applications, and review of literature of this versatile flap.

MATERIALS AND METHODS

A retrospective study of 82 cases of temporoparietal fascia flap in 71 patients, operated over a period of 10 years was conducted. Patients were grouped based on various clinical indications. The follow up period ranged from a minimum of 1 to a maximum of 10 years (Mean-four and a half years). All patients were analyzed for functional and aesthetic outcome using preoperative and postoperative photographs.

RESULTS

No significant complications were seen in our series. Only 2 out of 82 flaps had partial necrosis of flap (2.44%). Two patients who were operated for release of submucous fibrosis developed recurrence due to continued use of tobacco. The final outcome in one patient of ear reconstruction was unsatisfactory due to flap failure. The remaining patients had satisfactory functional and aesthetic outcomes (95.77%). None had other complications like temporal branch of facial nerve injury or alopecia along the scar line.

CONCLUSION

The TPFF is one of the most reliable and versatile flap in the head and neck region. It can also be reliably used as free fascial flap. When its advantages are combined with the surgeon's resourcefulness, various defects can be successfully reconstructed using the temporoparietal facia flap with satisfactory aesthetic and functional outcome.

摘要

目的

本报告详细介绍了我们在不同重建场景中使用颞顶筋膜瓣的经验,并讨论了我们的切取技术、临床应用以及对这种多功能皮瓣的文献综述。

材料与方法

对71例患者的82例颞顶筋膜瓣进行了回顾性研究,手术时间跨度为10年。根据各种临床指征对患者进行分组。随访时间最短为1年,最长为10年(平均4.5年)。使用术前和术后照片对所有患者的功能和美学效果进行分析。

结果

我们的系列研究中未发现明显并发症。82个皮瓣中只有2个出现部分皮瓣坏死(2.44%)。2例因黏膜下纤维化松解而手术的患者因持续吸烟而复发。1例耳部重建患者因皮瓣失败最终效果不满意。其余患者的功能和美学效果令人满意(95.77%)。无一例出现其他并发症,如面神经颞支损伤或瘢痕沿线脱发。

结论

颞顶筋膜瓣是头颈部最可靠、最通用的皮瓣之一。它也可可靠地用作游离筋膜瓣。当它的优点与外科医生的智慧相结合时,使用颞顶筋膜瓣可以成功重建各种缺损,获得令人满意的美学和功能效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e55a/3897092/825bc7a2a65b/IJPS-46-493-g001.jpg

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