Wang Qianwen, Song Weiming, Hou Dianju, Wang Jiaqi
Beijing, China From the Head and Neck Cosmetic Surgery Center of Beijing Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College.
Plast Reconstr Surg. 2015 May;135(5):1461-1471. doi: 10.1097/PRS.0000000000001157.
Forehead flaps have been used in the reconstruction of one particular faciocervical region, such as the nose and periorbital unit. The aims of the present study were to determine whether all the unit/multiunits of the face and neck could be aesthetically reconstructed by using expanded forehead flaps and to propose a strategy for flap selection for the reconstruction of different faciocervical units.
The authors systematically reviewed the application of expanded forehead flaps for cervicofacial rehabilitation in their center from 2000 to 2013.
Four types of expanded forehead flaps were used for the faciocervical reconstruction of 143 patients. Type I was a pre-expanded local flap used for repairing defects of the partial forehead unit, subunits of the periorbital unit, or partial involvement of the two adjacent units. Type II was an expanded paramedian forehead flap used for resurfacing the nose, orbital unit, upper cheek unit, and partial involvement of these adjacent units. Type III was a bilateral pedicled expanded forehead flap for the reconstruction of the lower face and anterior neck. Type IV was a unilateral pedicled expanded forehead flap, based on the superficial temporal vessels, used to reconstruct the ipsilateral part of the middle face.
The four types of expanded forehead flap can be used for the reconstruction of different faciocervical units. Based on the location and size of the defect or lesion, the selection of these flaps can be planned preoperatively.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
额部皮瓣已用于某一特定面颈部区域的重建，如鼻和眶周单位。本研究的目的是确定是否可以使用扩张额部皮瓣对面部和颈部的所有单位/多单位进行美学重建，并提出针对不同面颈部单位重建的皮瓣选择策略。
作者系统回顾了2000年至2013年在其中心扩张额部皮瓣用于面颈部修复的应用情况。
四种类型的扩张额部皮瓣用于143例患者的面颈部重建。I型为预扩张局部皮瓣，用于修复部分额部单位、眶周单位亚单位或两个相邻单位的部分受累缺损。II型为扩张正中旁额部皮瓣，用于鼻、眶单位、上颊单位以及这些相邻单位的部分受累区域的表面修复。III型为双侧蒂扩张额部皮瓣，用于重建下面部和前颈部。IV型为基于颞浅血管的单侧蒂扩张额部皮瓣，用于重建中面部的同侧部分。
四种类型的扩张额部皮瓣可用于不同面颈部单位的重建。根据缺损或病变的位置和大小，可在术前规划这些皮瓣的选择。
临床问题/证据水平：治疗性，IV级。
