Shenoy Ashok, Patil Vijayraj S, Prithvi B S, Chavan P, Halkud Rajshekar
Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka 560029, India.
Department of Surgical Oncology, HCG Hospital, Bangalore 560027, India.
Int J Surg Oncol. 2013;2013:658989. doi: 10.1155/2013/658989. Epub 2013 Dec 29.
Head and Neck oncologic resections often leave complex defects which are challenging to reconstruct. The need of the hour is a versatile flap which has the advantages of both a regional flap (viz. reliable and easy to harvest) and a free flap (thin, pliable with good colour match). In this a study we assessed the usefulness of the supraclavicular artery flap in head and neck oncologic defects.
The flap was used as a pedicled fasciocutanous and was based on the transverse supraclavicular artery. We assessed this reconstructive option for complications as well as its and functional out comes.
Eleven cases underwent supraclavicular artery flap between 20011-2012 of which 5 were males and 6 females. Mean defect size was 5 cm × 6 cm. Nine donor sites were closed primarily and 1 required split skin grafting. We encountered one complete flap loss which was attributed to a band of constricting skin bridge over the vascular pedicle in a defect involving lateral third of midface. Two patient developed pharyngeocutaneous fistula (without flap loss) out of 3 patients who underwent augmentation pharyngoplasty post Near total laryngectomy.
Supra clavicular artery flap is a thin versatile, reliable, easy to harvest, with good cosmetic and functional outcome at both ends (recipient and donor) for reconstructing head and neck oncologic defects.
头颈部肿瘤切除术后常遗留复杂缺损,修复颇具挑战性。当前亟需一种多功能皮瓣,兼具区域皮瓣(即可靠且易于切取)和游离皮瓣(薄、柔韧且颜色匹配良好)的优点。在本研究中,我们评估了锁骨上动脉皮瓣在头颈部肿瘤缺损修复中的应用价值。
该皮瓣用作带蒂筋膜皮瓣,以锁骨上横动脉为蒂。我们评估了这种修复方法的并发症情况及其功能结局。
2011年至2012年间,11例患者接受了锁骨上动脉皮瓣修复,其中男性5例,女性6例。平均缺损大小为5厘米×6厘米。9个供区直接缝合,1个需植皮。我们遇到1例皮瓣完全坏死,原因是在涉及面中1/3外侧的缺损中,血管蒂上方有一条收缩性皮肤桥带。在3例近全喉切除术后行咽成形术的患者中,2例发生咽皮瘘(皮瓣未坏死)。
锁骨上动脉皮瓣薄且多功能、可靠、易于切取,在修复头颈部肿瘤缺损时,受区和供区两端均具有良好的美容和功能效果。