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锁骨上动脉岛状皮瓣在颌面部缺损重建中的应用:病例报告及文献复习。

Use of the supraclavicular artery island flap for reconstruction of maxillofacial defects: a case report and literature review.

机构信息

The Third Hospital of Mianyang & Sichuan Mental Health Center, Head, Neck and Maxillofacial Surgery & Thyroid Department, Mianyang, 621000, Sichuan, China.

Sichuan Cancer Hospital & Institute, Head and Neck Surgery, No.55, Section 4, South Renmin Road, Chengdu, Sichuan, 610041, People's Republic of China.

出版信息

BMC Surg. 2021 Apr 14;21(1):193. doi: 10.1186/s12893-020-00987-2.

Abstract

BACKGROUND

Free flaps are widely used in maxillofacial reconstruction; however, this approach was not feasible in the current case. It was not possible because the free flap method requires microvascular anastomosis expertise, which is difficult, time-consuming and costly.

CASE PRESENTATION

An 86-year-old woman suffered squamous cell carcinoma on the right side of her face, which resulted in a large soft-tissue defect. Here, we present a case of facial reconstruction from the inferior margin of the jaw to the top of the head. The size of the defect was 18.5 cm × 7.5 cm, which is rare for a patient of this age in the maxillofacial area. We used the supraclavicular artery island flap (SCAIFP) which measured 19.3 cm × 8.3 cm to repair the defect. After the operation, the flap survived without complications. Then, the patient was followed for 10 months and was satisfied with the aesthetic and functional results at the donor and recipient sites following the tumour resection. The tumour did not recur, and facial nerve function was preserved.

CONCLUSION

Our results provide a new choice for the reconstruction of large defects of the head and face, and expand the potential applications of the SCAIFP.

摘要

背景

游离皮瓣被广泛应用于颌面重建;然而,在当前的病例中,这种方法不可行。这是因为游离皮瓣方法需要微血管吻合技术,这是困难的、耗时的和昂贵的。

病例介绍

一位 86 岁的女性患者面部右侧患有鳞状细胞癌,导致大面积软组织缺损。在这里,我们报告了一例从下颌下缘到头顶的面部重建病例。缺损的大小为 18.5cm×7.5cm,对于颌面区域的这个年龄的患者来说非常罕见。我们使用了 19.3cm×8.3cm 的锁骨下动脉岛状皮瓣(SCAIFP)来修复缺损。手术后,皮瓣无并发症存活。然后,患者接受了 10 个月的随访,对肿瘤切除后供区和受区的美学和功能结果均满意。肿瘤未复发,面神经功能得以保留。

结论

我们的结果为头面部大缺损的重建提供了新的选择,并扩大了 SCAIFP 的潜在应用。

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