Luca Nicola, Santana Maria Josè, Festa Bianca Maria, Collurà Fabio, Righini Stefano
From the *Department of Clinical Sciences and Community Health, San Giuseppe Hospital-Multimedica Group, Università degli Studi di Milano, Milan, Italy; and †Department of Human Anatomy and Histology, Universidad Miguel Hernández de Alicante, Spain.
Ann Plast Surg. 2017 Dec;79(6):577-582. doi: 10.1097/SAP.0000000000001144.
The main purpose of head and neck reconstructive surgery is to provide anatomic restoration of the demolited region and to provide preservation and recovery of function. The anatomical investigations conducted over the years has enabled a detailed knowledge of human body vascularization, giving the opportunity to design and harvest more and more versatile and refined flaps, with increasingly satisfactory results. Even if in the last 2 decades free flaps have been considered a reconstructive criterion standard, they still determine a great physical impact for the patient and require a certain surgical experience. In particular, perforator flaps (based on vessels that, emerging from the main deep axis, supply superficial myofascial cutaneous tissues) represent the new reconstructive frontier, of which a wide variety of types has been described. Our purpose is to illustrate the preparation and harvesting of the transverse cervical artery perforator flap and the variety of its utilization in head and neck reconstruction. From February 2005 to May 2015, 41 reconstructions were performed, and not only for oncologic reasons. Thanks to its anatomical features, reduced donor site morbidity and rapid preparation, this flap is a safe and feasible alternative to most famous free and locoregional flaps. Because our outcomes in functional and aesthetic terms were mostly satisfying, we can assert that the transverse cervical artery perforator flap has an important role in an appropriate reconstructive strategy for head, neck, and oropharyngolaryngeal region.
头颈重建手术的主要目的是对受损区域进行解剖修复,并保留和恢复功能。多年来进行的解剖学研究使人们对人体血管化有了详细的了解,从而有机会设计和切取越来越多功能、精细的皮瓣,取得了越来越令人满意的效果。尽管在过去20年中,游离皮瓣一直被视为重建的标准术式,但它们仍会给患者带来巨大的身体影响,且需要一定的手术经验。特别是穿支皮瓣(基于从主要深部血管轴发出、供应浅部肌筋膜皮肤组织的血管)代表了新的重建前沿,目前已描述了多种类型。我们的目的是阐述颈横动脉穿支皮瓣的制备、切取及其在头颈重建中的多种应用。2005年2月至2015年5月,共进行了41例重建手术,且并非仅出于肿瘤学原因。由于其解剖学特点、供区并发症少及制备迅速,该皮瓣是大多数著名游离皮瓣和局部皮瓣安全可行的替代方案。鉴于我们在功能和美学方面的结果大多令人满意,我们可以断言,颈横动脉穿支皮瓣在头、颈及口咽喉区域合适的重建策略中具有重要作用。