Gunnarsson Gudjon Leifur, Thomsen Jorn Bo
Department of Plastic Surgery, Telemark Hospital, Skien, Norway; and Department of Plastic Surgery, Lillebaelt Hospital and Odense University Hospital, Denmark.
Plast Reconstr Surg Glob Open. 2016 Mar 22;4(3):e661. doi: 10.1097/GOX.0000000000000611. eCollection 2016 Mar.
Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our experience using freestyle facial perforator flaps, we have located areas where perforators are consistently found. This study is focused on a particular perforator lateral to the angle of the mouth; the modiolus and the versatile modiolus perforator flap.
A cohort case series of 14 modiolus perforator flap reconstructions in 14 patients and a color Doppler ultrasonography localization of the modiolus perforator in 10 volunteers.
All 14 flaps were successfully used to reconstruct the defects involved, and the location of the perforator was at the level of the modiolus as predicted. The color Doppler ultrasonography study detected a sizeable perforator at the level of the modiolus lateral to the angle of the mouth within a radius of 1 cm. This confirms the anatomical findings of previous authors and indicates that the modiolus perforator is a consistent anatomical finding, and flaps based on it can be recommended for several indications from the reconstruction of defects in the perioral area, cheek and nose.
The modiolus is a well-described anatomical area containing a sizeable perforator that is consistently present and readily visualized using color Doppler ultrasonography. We have used the modiolus perforator flap successfully for several indications, and it is our first choice for perioral reconstruction.
穿支皮瓣已得到充分认可，其作为随意型岛状皮瓣的实用性也得到公认。尽管多项解剖学研究显示出相似的一致性，但面部血管穿支的位置及穿支皮瓣的分类仍是一个有争议的话题。根据我们使用随意型面部穿支皮瓣的经验，我们已确定了穿支始终存在的区域。本研究聚焦于口角外侧的一个特定穿支；即口角肌及多功能口角肌穿支皮瓣。
对14例患者进行14例口角肌穿支皮瓣重建的队列病例系列研究，并对10名志愿者进行口角肌穿支的彩色多普勒超声定位。
所有14块皮瓣均成功用于修复相关缺损，穿支的位置正如预期位于口角肌水平。彩色多普勒超声研究在口角外侧口角肌水平半径1厘米范围内检测到一个较大的穿支。这证实了既往作者的解剖学发现，并表明口角肌穿支是一个恒定的解剖学发现，基于该穿支的皮瓣可推荐用于口周区域、面颊和鼻部缺损修复的多种适应证。
口角肌是一个描述详尽的解剖区域，包含一个始终存在且使用彩色多普勒超声易于观察到的较大穿支。我们已成功将口角肌穿支皮瓣用于多种适应证，且它是我们口周重建的首选皮瓣。
