Honeybrook Adam, Athavale Sanjay M, Rangarajan Sanjeet V, Rohde Sarah L, Netterville James L
Duke University Otolaryngology Head and Neck Surgery & Communication Sciences, Durham, NC, United States.
Vanderbilt University Medical Center, Department of Otolaryngology - Head and Neck Surgery, Nashville, TN, United States.
Am J Otolaryngol. 2017 May-Jun;38(3):291-296. doi: 10.1016/j.amjoto.2017.01.026. Epub 2017 Jan 27.
Ablative procedures of the head and neck often result in significant facial and cervical irregularities and cosmetic asymmetry. The deformity resulting from ablative procedures of the head and neck is a significant source of cosmetic morbidity and postoperative dissatisfaction. Reconstruction of post-ablative defects in the head and neck can employ a broad range of techniques, ranging from primary closure to free tissue transfer. The free dermal fat graft (FDFG) is one such option and has been used to repair volume defects of varying sizes after common head and neck procedures such as parotidectomy. However, its use is largely undocumented in the literature. We seek to further illustrate the FDFG as an alternate method of reconstruction of head and neck defects.
Non-randomized retrospective analysis.
The medical records of all patients who underwent primary autologous abdominal FDFG reconstruction of head and neck defects by a single surgeon at Vanderbilt University Medical Center from January 1997 to August 2010 were reviewed. All patients were called in order to assess their post-operative cosmetic satisfaction.
Sixty-two patients were analyzed. Only three patients were found to have post-operative complications directly related to the FDFG. No complications were found at the donor site. Based on a telephone survey, the majority of patients were satisfied post-operatively with their cosmetic outcomes in the primary site and donor site.
From our experience the FDFG is a cosmetically and functionally advantageous option for reconstruction of ablative procedures of the head and neck.
头颈部消融手术常常导致明显的面部和颈部畸形以及美容不对称。头颈部消融手术造成的畸形是美容并发症和术后不满的重要来源。头颈部消融术后缺损的重建可采用多种技术,从一期缝合到游离组织移植。游离真皮脂肪移植(FDFG)就是其中一种选择,已被用于修复腮腺切除术等常见头颈部手术后不同大小的容积性缺损。然而,其应用在文献中很大程度上未被记载。我们试图进一步说明FDFG作为头颈部缺损重建的另一种方法。
非随机回顾性分析。
回顾了1997年1月至2010年8月在范德比尔特大学医学中心由一名外科医生对所有接受头颈部缺损一期自体腹部FDFG重建的患者的病历。所有患者均被电话随访以评估其术后美容满意度。
分析了62例患者。仅发现3例患者有与FDFG直接相关的术后并发症。供区未发现并发症。基于电话调查,大多数患者术后对其原发部位和供区的美容效果满意。
根据我们的经验,FDFG是头颈部消融手术重建在美容和功能方面的一个有利选择。