Liu Longcan, Liu Yuanbo, Zang Mengqing, Zhu Shan, Chen Bo, Li Shanshan
No.11 Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical School, Beijing, 100144, P.R.China.
No.11 Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical School, Beijing, 100144,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Nov 15;31(11):1358-1362. doi: 10.7507/1002-1892.201706019.
To explore the feasibility and effectiveness of sideburn reconstruction using the expanded island scalp flap based on the parietal branch of the superficial temporal vessel.
Between February 2012 and April 2015, 7 patients underwent sideburn reconstruction. There were 3 males and 4 females with an average age of 15 years (range, 4-44 years). The etiologies included burn injury in 3 cases, trauma in 1 case, radiation therapy in 1 case, and congenital melanocytic nevus in 2 cases. The size of the sideburn defects ranged from 5.0 cm×3.5 cm to 16.0 cm×10.0 cm. At the first-stage, according to the sideburn defect, a tissue expander of the appropriate size was inserted beneath the superficial temporal fascia which containing the parietal branch of the superficial temporal vessel. Postoperatively, regular saline injection was commenced. After 3-6 months of the first-stage surgery, the expander was adequately inflated. While the second-stage surgery was performed, the lesion was excised and the tissue expander removed. The expanded island scalp flap based on the parietal branch of the superficial temporal vessel was harvested and advanced towards the defect of the sideburn according to the contralateral normal one, and the size of flap ranged from 8 cm×3 cm to 17 cm×11 cm. The donor site was closed primarily.
All flaps survived and the wound and donor sites were healed primarily without any complication. All patients were followed up 1-36 months (mean, 9.8 months). The profile, hair density, and hair direction of the new sideburn were similar to the contralateral sideburn. In 1 patient, the reconstructed sideburn was a little larger than the contralateral normal one. After laser hair removal, the patient was satisfied with the appearance.
The expanded island scalp flap based on the parietal branch of the superficial temporal vessel provides an effective option for the sideburn reconstruction, which presents with the similar appearance to the contralateral one.
探讨应用基于颞浅血管顶支的扩张岛状头皮瓣进行鬓角再造的可行性及有效性。
2012年2月至2015年4月，7例患者接受鬓角再造手术。其中男性3例，女性4例，平均年龄15岁（范围4 - 44岁）。病因包括烧伤3例、外伤1例、放射治疗1例、先天性黑素细胞痣2例。鬓角缺损大小为5.0 cm×3.5 cm至16.0 cm×10.0 cm。一期手术时，根据鬓角缺损情况，在包含颞浅血管顶支的颞浅筋膜下植入合适大小的组织扩张器。术后开始定期注射生理盐水。一期手术后3 - 6个月，扩张器充分扩张。二期手术时，切除病变组织并取出组织扩张器。切取基于颞浅血管顶支的扩张岛状头皮瓣，参照对侧正常鬓角向鬓角缺损区推进，皮瓣大小为8 cm×3 cm至17 cm×11 cm。供区直接缝合。
所有皮瓣均成活，伤口及供区均一期愈合，无任何并发症。所有患者随访1 - 36个月（平均9.8个月）。再造鬓角的外形、毛发密度及毛发方向与对侧相似。1例患者再造鬓角略大于对侧正常鬓角，经激光脱毛后，患者对外观满意。
基于颞浅血管顶支的扩张岛状头皮瓣为鬓角再造提供了一种有效的选择，再造后的鬓角外观与对侧相似。
