重新审视颞浅动脉耳后皮瓣,采用基于解剖学的逐步蒂部解剖法用于面部特定亚单位重建。

Revisiting the temporal artery posterior auricular skin flap with an anatomical basis stepwise pedicle dissection for use in targeted facial subunit reconstruction.

作者信息

Ganry Laurent, Ettinger Kyle S, Rougier Guillaume, Qassemyar Quentin, Fernandes Rui P

机构信息

Faculté de Médecine, Sorbonne Université, Paris, France.

Department of Plastic and Reconstructive Surgery, University Hospital Armand-Trousseau, Paris, France.

出版信息

Head Neck. 2020 Nov;42(11):3153-3160. doi: 10.1002/hed.26362. Epub 2020 Jul 20.

Abstract

BACKGROUND

This study demonstrates the anatomy of the pedicled temporal artery posterior auricular skin (TAPAS) flap, its variable arc of rotation based on stepwise dissection, and case reports demonstrating clinical use. This flap provides excellent color match and ultrathin tissue for targeted reconstruction of small- to medium-sized facial subunit defects.

METHODS

Twenty-six cadaver dissections were performed. The authors measured the reach and rotation limits of the flap in a pedicled fashion depending on a stepwise approach for vascular pedicle dissection. Two clinical cases demonstrating maximum arc of rotation are seen.

RESULTS

The pedicled TAPAS flap maximal rotation limits allow for reconstruction of facial subunits encompassing nearly the entire ipsilateral face. No venous congestion, wound complications, or partial/total flap loss were encountered with extreme clinical applications.

CONCLUSION

The pedicled TAPAS flap has extensive versatility for reconstruction of a variety of facial subunit defects. The flap also has, in theory, multiple applications for intraoral reconstruction.

摘要

背景

本研究展示了带蒂颞浅动脉耳后皮肤(TAPAS)皮瓣的解剖结构、基于逐步解剖的可变旋转弧度,以及展示其临床应用的病例报告。该皮瓣为中小面部亚单位缺损的靶向重建提供了出色的颜色匹配和超薄组织。

方法

进行了26例尸体解剖。作者根据血管蒂解剖的逐步方法,以带蒂方式测量了皮瓣的延伸范围和旋转限度。展示了两个临床病例,显示出最大旋转弧度。

结果

带蒂TAPAS皮瓣的最大旋转限度允许对面部亚单位进行重建,几乎涵盖整个同侧面部。在极端临床应用中,未遇到静脉淤血、伤口并发症或部分/全部皮瓣丢失的情况。

结论

带蒂TAPAS皮瓣在重建各种面部亚单位缺损方面具有广泛的通用性。从理论上讲,该皮瓣在口腔内重建中也有多种应用。

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