Kim Kyung Pil, Sim Ho Seup, Choi Jun Ho, Lee Sam Yong, Lee Do Hun, Kim Seong Hwan, Kim Hong Min, Hwang Jae Ha, Kim Kwang Seog
Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea.
Arch Craniofac Surg. 2016 Dec;17(4):190-197. doi: 10.7181/acfs.2016.17.4.190. Epub 2016 Dec 23.
The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices.
This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction.
The average defect size was 6.4 cm, and the average flap size was 47.3 cm. Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus.
The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.
颊旋转皮瓣血供充足、皮瓣面积大,且灵活易操作。它已被用于颊部、下眼睑或内外眦部缺损的修复。对于鼻中央的大缺损,曾使用过正中旁额部皮瓣,但由于额部会遗留瘢痕,尽管缺损区域肤色得以保留,患者仍不太愿意接受。然而,颊部皮瓣在美容方面更具优势,因为它利用了相邻的大面积皮瓣。因此,本研究旨在通过临床实践证明其多功能性。
这是一项回顾性病例研究,对2008年至2015年期间38例切除面部肿物并采用颊旋转皮瓣进行修复的患者进行分析。这些缺损包括颊部(16例)、下眼睑(12例)、鼻部(3例)、内眦部(3例)、外眦部(2例)和耳前区(2例)。采用颊黏膜修复眼睑结膜,采用皮肤移植修复鼻黏膜。
平均缺损大小为6.4 cm,平均皮瓣大小为47.3 cm。所有皮瓣均顺利恢复,未出现诸如倾斜异常、下眼睑内翻或外翻等并发症,但在3例鼻侧壁修复病例中,由于鼻唇沟处出现“狗耳”畸形,需要进行修复手术。
颊旋转皮瓣可用于替代正中旁额部皮瓣,修复大的鼻侧壁缺损以及既往的内外眦部缺损。