Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
J Craniofac Surg. 2022;33(5):1322-1326. doi: 10.1097/SCS.0000000000008397. Epub 2021 Dec 1.
The superficial temporal artery (STA) frontal branch flap is susceptible to venous congestion because of its unpredictable and variable outflow. The authors applied indocyanine green angiogra-phy in identifying the superficial temporal vessels to help surgeons with proper flap designs to avoid severe complications. A retrospective review from 2015 to 2020 was conducted. All the patients who underwent indocyanine green angiography before forehead flap transfer for facial defect reconstruction were reviewed. The STA and vein were observed using indocyanine green angiography preoperatively. The relationship between the artery and vein was investigated. The venous anatomy was analyzed to guide the pedicle design. The survival of the flap and complications were assessed. A total of 12 patients were identified and included in this study. Indocyanine green angiography allows clear visualization of the detailed anatomy of the STA and vein. The frontal branch of the vein had great variations and generally diverged from the arterial branch. The tiny venae comitantes provided sufficient drainage for 2 small forehead flaps. The frontal branch of the vein entered the forehead and was used as the outflow channel in 4 patients. The parietal branch of the vein, which consistently gave off secondary tributaries to the superior forehead, was included in the pedicle in 6 patients. All flaps survived without complications. indocyanine green angiography provided accurate localization of the superficial temporal vessels. This technique may be helpful in the precise planning forehead flap surgeries and in avoiding the risk of venous congestion.
额部皮瓣的颞浅动脉（STA）额支容易发生静脉淤血，因为其流出具有不可预测性和变异性。作者应用吲哚菁绿血管造影术来识别颞浅血管，以帮助外科医生进行适当的皮瓣设计，避免严重并发症。回顾性研究了 2015 年至 2020 年的数据。所有因面部缺损重建而行额部皮瓣转移术的患者均接受了吲哚菁绿血管造影术。术前行吲哚菁绿血管造影术观察 STA 和静脉。研究了动脉与静脉之间的关系。分析静脉解剖结构以指导蒂设计。评估皮瓣的存活和并发症。共纳入 12 例患者进行本研究。吲哚菁绿血管造影术可清晰显示 STA 和静脉的详细解剖结构。静脉的额支分支变化较大，通常与动脉分支分开。细小的伴行静脉为 2 个小的额部皮瓣提供了足够的引流。4 例患者将静脉额支作为流出通道进入额部。6 例患者的静脉顶支有恒定的次级分支供应额部上方，将其包含在蒂内。所有皮瓣均存活且无并发症。吲哚菁绿血管造影术可准确定位颞浅血管。该技术有助于精确规划额部皮瓣手术，避免静脉淤血的风险。
