Singh T, Andi K
Department of Maxillofacial Surgery, St George's Hospital, Blackshaw Rd, SW17 0QT, London, United Kingdom.
Br J Oral Maxillofac Surg. 2017 Apr;55(3):270-273. doi: 10.1016/j.bjoms.2016.12.012. Epub 2017 Jan 11.
The iliac crest free flap is commonly used in maxillofacial reconstruction, and is typically supplied by the deep circumflex iliac artery (DCIA). However, the iliolumbar artery is an alternative blood supply that can potentially be used in such reconstructions. We describe the anatomy of the iliolumbar artery and review publications about its clinical use. We raised four cadaveric iliac crest free flaps using both the DCIA and the iliolumbar artery to illustrate its use in reconstructing maxillofacial defects. It provided a longer pedicle for microvascular anastomosis than the DCIA, was more versatile in orientation of the flap, and allowed the chance of anastomosing both pedicles to "super-charge" the flap's blood supply. We describe a patient in whom this flap was used successfully, which shows that the iliolumbar artery is a suitable pedicle to augment (or replace) the DCIA in an iliac crest free flap.
髂嵴游离皮瓣常用于颌面重建，通常由旋髂深动脉（DCIA）供血。然而，髂腰动脉是一种可供选择的血供，有可能用于此类重建。我们描述了髂腰动脉的解剖结构，并回顾了有关其临床应用的文献。我们使用DCIA和髂腰动脉制作了4个尸体髂嵴游离皮瓣，以说明其在重建颌面缺损中的应用。它为微血管吻合提供了比DCIA更长的蒂，皮瓣方向更具灵活性，并且有机会将两个蒂都进行吻合以“增强”皮瓣的血供。我们描述了一名成功使用该皮瓣的患者，这表明在髂嵴游离皮瓣中，髂腰动脉是增强（或替代）DCIA的合适蒂。
