Brandtner C, Hachleitner J, Buerger H, Gaggl A
Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Department of Oral and Maxillofacial Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Int J Oral Maxillofac Surg. 2015 Jun;44(6):692-6. doi: 10.1016/j.ijom.2015.03.006. Epub 2015 Mar 30.
In midface defects including the orbit (Brown class III and IV), no single flap can provide adequate reconstruction. In this technical note, the combination of vascularized iliac crest flap and vascularized medial femoral condyle flap (MFC) is described. The vascularized iliac crest flap is reported to be the gold standard for maxilla reconstruction. There is, however, no consensus on the best method for orbital and nasal wall reconstruction. The MFC flap can be harvested as a thin corticoperiosteal flap or as an osteomyocutaneous flap. Due to the periosteal blood supply, this flap can be customized for an individual defect of the upper hemi-midface. It is therefore of great benefit in orbital and nasal wall reconstruction. By combining the deep circumflex iliac artery (DCIA) bone flap and the MFC flap, the best standard reconstruction technique of the hemi-maxilla can be combined with a new anatomical precise microvascular reconstruction technique of the orbit. A nearly symmetric midface appearance can be achieved.
在包括眼眶在内的面中部缺损（Brown III级和IV级）中，没有单一的皮瓣能够提供充分的重建。在本技术说明中，描述了带血管蒂的髂嵴皮瓣和带血管蒂的股骨内侧髁皮瓣（MFC）的联合应用。带血管蒂的髂嵴皮瓣据报道是上颌骨重建的金标准。然而，对于眼眶和鼻壁重建的最佳方法尚无共识。MFC皮瓣可以作为薄的骨膜皮瓣或骨肌皮瓣切取。由于骨膜血供，该皮瓣可根据上半面中部的个体缺损进行定制。因此，它在眼眶和鼻壁重建中具有很大的优势。通过将旋髂深动脉（DCIA）骨瓣和MFC皮瓣联合应用，可以将半上颌骨的最佳标准重建技术与一种新的眼眶解剖精确微血管重建技术相结合。可以实现近乎对称的面中部外观。
