Department of Maxillo-Facial and Plastic Reconstructive Surgery.
Department of Neurosurgery, E.O. Ospedali Galliera Via Mura delle Cappuccine 14, Genoa, Italy.
J Craniofac Surg. 2021 Jun 1;32(4):1517-1520. doi: 10.1097/SCS.0000000000007056.
Extended tumor resection in the middle third of the face leads to complex defects: wide, 3-dimensional, and multitissutal. Appropriate reconstruction is challenging but mandatory to obtain a functional and aesthetic outcome for the preservation of an acceptable quality of life. Three-dimensional combined flaps and multistep procedures concur to reach this scope.This is exemplified on the treatment of an invasive recurrent skin malignancy involving the cheek and maxillary bone in association with a full-thickness nasal defect. Reconstruction was performed with 3-dimensional multifolded anterolateral tigh chimeric flap, followed by multistep procedure respecting the aesthetic nasal reconstruction guidelines. Reconstructive surgery had the following targets: targets: rebuilding the oral and nasal lining, filling the paranasal cavities, covering the facial skin defect respecting the aesthetic unit concept and providing a proper support to the facial structures.The aesthetic unit concept has to be respected throughout all steps, from tumor debulking, to reconstruction and even for the management of complications.
广泛、三维和多组织。为了获得功能和美观的结果，以保持可接受的生活质量，适当的重建是具有挑战性但也是强制性的。三维联合皮瓣和多步手术有助于实现这一目标。这在治疗累及脸颊和上颌骨的侵袭性复发性皮肤恶性肿瘤伴全层鼻缺损的患者中得到了例证。采用三维折叠的前外侧阔筋膜张肌复合皮瓣进行重建，然后根据美学鼻重建指南进行多步手术。重建手术的目标包括：重建口腔和鼻腔衬里，填充副鼻窦，覆盖面部皮肤缺损，尊重美学单位概念，并为面部结构提供适当的支撑。在所有步骤中，包括肿瘤切除术、重建术，甚至是并发症的处理，都要尊重美学单位概念。
