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显微外科游离肩胛下动脉穿支皮瓣/腹壁下动脉穿支皮瓣修复半侧颜面短小畸形患者面部轮廓

Microsurgical SCIA/SIEA flap for facial contour correction in patient with hemifacial microsomia.

作者信息

Battisti Andrea, Cassoni Andrea Cassoni, Bartoli Davina, Monaca Marco Della, Barbera Giorgio, Cerbelli Edoardo, Valentini Valentino

出版信息

Ann Ital Chir. 2017;88.

Abstract

AIM

We propose our experience in soft tissue reconstruction in Hemifacial microsomia using a free fascioadiposal flap.

MATERIAL OF STUDY

Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial malformation of one or both sides of the lower face. A 18-year-old female presented with hemifacial microsomia involving the left side. A free SCIA/SIEA fascioadiposal flap was transferred to the left face for soft tissue augmentation.

RESULTS

The immediate postoperative course of the patient was uneventful, with no complication and adequate augmentation in contour deformity was achieved. One year after the procedure, the patient presented a good resolution of the deformity with improved facial symmetry DISCUSSION: Reconstruction for facial contour deformities is still a challenging process and treatment for most cases is achieved only by soft tissue augmentation. Several microsurgical flaps have been proposed for restoration of facial asymmetry and improvement of facial volume and contour in these patients: deltopectoral, parascapular, anterolateral thigh, groin and deep inferior epigastric. This article reports our experience in facial soft tissue reconstruction with microsurgical superficial circumflex iliac artery/superficial inferior epigastric artery (SCIA/SIEA) fascioadiposal flap transfer in patient with HFM. This flap, which has a dual blood vascularization and pliant soft tissue, can provide an ideal treatment for soft tissue augmentation in hemifacial microsomia with optimal aesthetic results both in the face and at the donor site.

CONCLUSION

The free SCIA/SIEA fascioadiposal flap is a optimal choise option for soft tissue reconstruction with good esthetical outcome both in the face and at the donor site.

KEY WORDS

Facial augmentation, Free flaps, Free SCIA/SIEA flap, Hemifacial microsomia.

摘要

目的

我们介绍使用游离筋膜脂肪瓣进行半侧颜面短小畸形软组织重建的经验。

研究材料

半侧颜面短小畸形(HFM)是一种先天性疾病,其特征为下脸一侧或双侧的颅面畸形。一名18岁女性患有左侧半侧颜面短小畸形。将游离的旋髂浅动脉/腹壁浅动脉筋膜脂肪瓣转移至左侧面部以增加软组织量。

结果

患者术后即刻过程顺利,无并发症,轮廓畸形得到充分改善。术后一年,患者畸形得到良好矫正,面部对称性改善。

讨论

面部轮廓畸形的重建仍然是一个具有挑战性的过程,大多数病例的治疗仅通过软组织增加来实现。已经提出了几种显微外科皮瓣用于恢复这些患者的面部不对称性并改善面部容积和轮廓:胸三角皮瓣、肩胛旁皮瓣、股前外侧皮瓣、腹股沟皮瓣和腹壁下深动脉皮瓣。本文报告了我们使用显微外科旋髂浅动脉/腹壁浅动脉(SCIA/SIEA)筋膜脂肪瓣转移对HFM患者进行面部软组织重建的经验。该皮瓣具有双重血液供应和柔软的软组织,可为半侧颜面短小畸形的软组织增加提供理想的治疗方法,在面部和供区均能获得最佳美学效果。

结论

游离SCIA/SIEA筋膜脂肪瓣是软组织重建的最佳选择,在面部和供区均能获得良好的美学效果。

关键词

面部增大、游离皮瓣、游离SCIA/SIEA皮瓣、半侧颜面短小畸形

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