Prakash Divya, Balakrishnan T M, Jaganmohan J
Department of Plastic, Reconstructive and Faciomaxillary Surgery, Madras Medical College, Chennai, India.
Indian J Plast Surg. 2021 Apr;54(2):144-151. doi: 10.1055/s-0041-1729507. Epub 2021 Jun 23.
The glabrous, thin, and pliable texture of lateral arm flap with no loss of any axial vessel of the limb renders it a good choice for hemiglossectomy defect reconstruction. The main caveat of this flap harvest is the loss of sensation in the distribution of posterior antebrachial cutaneous nerve (PABCN). In this article, we present two strategic sites and techniques to preserve the integrity of PABCN and at the same time harvesting lateral arm flap with a lengthy lower lateral cutaneous nerve of arm for the neurotization. The outcome of this function-preserving neurotized lateral arm free flap in the reconstruction of hemiglossectomy defects is analyzed and presented in this article. Ninety percent of the patients attained grade 3 score in objective assessment, leading to a significant -value of 0.02 with this technique. All had preservation of sensation in the distribution of PABCN. Our technique of harvest and neurotization has brought good functional recovery of the oral cavity with preservation of PABCN.
上臂外侧皮瓣质地无毛、薄且柔韧，肢体的任何轴型血管均无损伤，使其成为舌半侧切除缺损重建的理想选择。该皮瓣切取的主要问题是前臂后皮神经（PABCN）分布区域感觉丧失。在本文中，我们介绍了两个策略性部位和技术，以保留PABCN的完整性，同时切取带有较长臂外侧下皮神经的上臂外侧皮瓣用于神经移植。本文分析并展示了这种保留功能的神经化上臂外侧游离皮瓣在舌半侧切除缺损重建中的效果。在客观评估中，90%的患者达到3级评分，该技术的P值显著为0.02。所有患者PABCN分布区域的感觉均得以保留。我们的切取和神经移植技术在保留PABCN的同时，使口腔功能得到了良好恢复。
