Moon Prashant, Mishra Girish S, Patel Jaykumar V
Department of General Surgery, A.C.P.M. Medical College, Dhule, Maharastra 424002 India.
Department of ENT and head and neck surgery, Pramukh Swami Medical College and Shri Krishna Hospital, Bhaikaka University, Karamsad, Anand, Gujarat 388325 India.
Indian J Otolaryngol Head Neck Surg. 2023 Mar;75(1):140-144. doi: 10.1007/s12070-022-03259-y. Epub 2022 Nov 9.
Through and through complex oro-mandibular defect usually involves buccal mucosa, mandibular segment, lip, and outer cheek skin. Reconstruction of such extensive three-dimensional defects pose a great challenge to reconstructive surgeons which requires use of two flaps. There are diverse options for such types of defects like use two pedicled flaps, one free flap, one pedicled flap or use of two free flaps. Amongst them the use of dual free flaps is ideal for the reconstruction. Commonly used dual free flaps are free fibula osteocutaneous flap for mandible, buccal mucosal defect and free radial artery flap or antero-lateral flap for cheek defect. The major disadvantages of using these two free flaps include two different sites for flap harvest, more time for harvesting and increased overall surgery time. We present our experience of reconstruction of large oro-mandibular defect using free osteo-cutaneous fibula flap and lateral sural artery free flap from single limb in six patients between January 2019 and December 2020. Minimum follow up was 6 months.
贯通性复杂口颌部缺损通常累及颊黏膜、下颌骨段、唇部和颊部外侧皮肤。重建如此大面积的三维缺损对重建外科医生来说是一项巨大挑战,这需要使用两个皮瓣。对于这类缺损有多种选择,比如使用两个带蒂皮瓣、一个游离皮瓣、一个带蒂皮瓣或使用两个游离皮瓣。其中,使用双游离皮瓣进行重建是理想的选择。常用的双游离皮瓣有用于下颌骨和颊黏膜缺损的游离腓骨骨皮瓣,以及用于颊部缺损的游离桡动脉皮瓣或前外侧皮瓣。使用这两个游离皮瓣的主要缺点包括皮瓣切取部位不同、切取时间更长以及手术总时间增加。我们介绍了2019年1月至2020年12月期间,对6例患者使用游离腓骨骨皮瓣和单肢体的腓肠外侧动脉游离皮瓣重建大口颌部缺损的经验。最短随访时间为6个月。