Dizdarevic Dino, Masic Tarik, Muslic Edi
Clinic for Maxillofacial Surgery, University Clinical Center in Sarajevo, Sarajevo, Bosnia and Herzegovina.
Clinic for Plastic and Reconstructive Surgery, University Clinical Center in Sarajevo, Sarajevo, Bosnia and Herzegovina.
Med Arch. 2017 Oct;71(5):338-340. doi: 10.5455/medarh.2017.71.338-340.
Flap of the temporal muscle (m. temporalis) with its natural position, its mass and its length, compared with other bound and free microvascular flaps, is the method of choice for covering the middle part of the face after the removal of large tumor masses.
The study included a sample of 36 patients who were surgically treated due to malignant process at the middle face level with the performed partial, total or bilateral maxillectomy at the Clinic for Maxillofacial Surgery, University Clinical Center in Sarajevo. The sample is divided into three groups.
The usual procedure of lifting the temporal flap in the first group, at the second extension of the coronoid processus. A group of three-elongated myofascial flap, which includes lifting the muscle along with deep temporal branches of maxillary artery with deep temporal fascia, its two layers and associated stem of thesuperficial temporal artery.
Statistical analysis of the length indicated that in group III the mean length was 9.83 cm, group II- 8.25, and group I- 6 cm. The longest segmental lobe in group three provides safer work and the length of the lifted lobe with double vascular stem. This provides coverage of defects that cross over the median line of the middle face. The results coincide with the comparative world studies.
For large defects at the meddle part of the face that overlap the median line, an extraordinary solution is elongated myofascial flap with double vascular supply, with a larger flap mass and a length of about 9.83 cm.
颞肌瓣凭借其天然位置、质量和长度，与其他带蒂及游离微血管瓣相比，是切除大型肿瘤块后覆盖面部中部的首选方法。
该研究纳入了36例患者样本，这些患者因面部中部的恶性病变在萨拉热窝大学临床中心颌面外科诊所接受了部分、全部或双侧上颌骨切除术。样本分为三组。
第一组采用常规的颞瓣提升手术，在冠状突的第二个延伸处进行。第二组采用一种三延长肌筋膜瓣，即将肌肉连同上颌动脉的颞深支与颞深筋膜、其两层以及颞浅动脉的相关干一起提起。
长度的统计分析表明，第三组的平均长度为9.83厘米，第二组为8.25厘米，第一组为6厘米。第三组中最长的节段性叶提供了更安全的操作，且带有双血管干的提起叶的长度能够覆盖跨越面部中部中线的缺损。结果与世界范围内的比较研究相符。
对于面部中部跨越中线的大型缺损，一种特殊的解决方案是采用具有双血管供应的延长肌筋膜瓣，其瓣体质量更大，长度约为9.83厘米。
