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颈面皮瓣在肿瘤切除后面部皮肤颊部缺损修复中的应用：两例报告。

Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases.

机构信息

Department of Surgery, University of Ilorin Teaching Hospital, Ilorin. Nigeria.

出版信息

Afr Health Sci. 2023 Mar;23(1):511-514. doi: 10.4314/ahs.v23i1.53.

DOI:10.4314/ahs.v23i1.53
PMID:37545977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10398496/
Abstract

Reconstructing a large cutaneous cheek defect post tumour excision poses a great challenge to the reconstructive surgeon. The surgical options are limited for a functional and aesthetically acceptable outcome. The microvascular free flap which is currently the gold standard is still not a common place in our practice in Nigeria. Cervicofacial flap, a single stage procedure, offers an excellent alternative as it can be done for patients who are not fit for prolonged anesthesia and can even be undertaken under local anesthesia. We presented two cases of patients with cheek tumors who had wide local excision after histological diagnosis of Basal Cell Carcinoma and Basaloid Squamous Cell Carcinoma. Both defects were closed with cervicofacial flap under general anesthesia. The flaps survived with no loss. Cheek defect reconstruction with cervicofacial flap is simple, reliable and with similar favourable aesthetic outcome when compared with free flap procedure. It should be an important part of a reconstructive surgeon armamentarium.

摘要

重建肿瘤切除术后的大面积面颊缺损对重建外科医生来说是一个巨大的挑战。对于功能和美学上可接受的结果，手术选择是有限的。目前作为金标准的游离皮瓣在我们尼日利亚的实践中仍然不常见。颈面瓣是一种单一阶段的手术，提供了一个极好的替代方法，因为它可以用于那些不能耐受长时间麻醉的患者，甚至可以在局部麻醉下进行。我们介绍了两例颊部肿瘤患者，他们在组织学诊断为基底细胞癌和基底样鳞状细胞癌后进行了广泛的局部切除。两名患者均在全麻下采用颈面瓣关闭缺损。皮瓣均存活，无丢失。与游离皮瓣手术相比，颈面瓣用于颊部缺损重建既简单可靠，又具有相似的良好美学效果。它应该成为重建外科医生手术器械的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/06265048521b/AFHS2301-0511Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/0efcf5ff430d/AFHS2301-0511Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/8cda11275099/AFHS2301-0511Fig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/77c4ef7b97bd/AFHS2301-0511Fig2b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/334e73cdaa1f/AFHS2301-0511Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/81d1924d63db/AFHS2301-0511Fig7a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/505f72a344d7/AFHS2301-0511Fig7b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/ab1a054a76ca/AFHS2301-0511Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/4df2cd6158c2/AFHS2301-0511Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/06265048521b/AFHS2301-0511Fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/0efcf5ff430d/AFHS2301-0511Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/8cda11275099/AFHS2301-0511Fig2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/77c4ef7b97bd/AFHS2301-0511Fig2b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/334e73cdaa1f/AFHS2301-0511Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/81d1924d63db/AFHS2301-0511Fig7a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/505f72a344d7/AFHS2301-0511Fig7b.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/ab1a054a76ca/AFHS2301-0511Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/4df2cd6158c2/AFHS2301-0511Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12cd/10398496/06265048521b/AFHS2301-0511Fig6.jpg

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本文引用的文献

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Modified Cervicofacial Flap for Large Cheek Defect Reconstruction under Local Anesthesia.局部麻醉下改良颈面部皮瓣修复大面积面颊缺损
Case Rep Surg. 2019 Apr 4;2019:1960609. doi: 10.1155/2019/1960609. eCollection 2019.
2
Cervicofacial Flap: Can We Save Patient's Sideburns?颈面部皮瓣：我们能保留患者的鬓角吗？
Arch Craniofac Surg. 2017 Sep;18(3):172-178. doi: 10.7181/acfs.2017.18.3.172. Epub 2017 Sep 26.
3
The use of cervicofacial flap in maxillofacial reconstruction.颈面部皮瓣在颌面重建中的应用。
Oral Maxillofac Surg Clin North Am. 2014 Aug;26(3):389-400. doi: 10.1016/j.coms.2014.05.007. Epub 2014 Jun 26.
4
Comparing rates of distal edge necrosis in deep-plane vs subcutaneous cervicofacial rotation-advancement flaps for facial cutaneous Mohs defects.比较深部平面与皮下颈面部旋转推进皮瓣修复面部皮肤Mohs缺损时远端边缘坏死的发生率。
JAMA Facial Plast Surg. 2014 Jan-Feb;16(1):31-5. doi: 10.1001/jamafacial.2013.20.
5
The versatile application of cervicofacial and cervicothoracic rotation flaps in head and neck surgery.头颈部外科中颈侧及颈胸旋转皮瓣的多功能应用。
World J Surg Oncol. 2011 Oct 23;9:135. doi: 10.1186/1477-7819-9-135.
6
The subcutaneous cervicofacial flap revisited.再探皮下颈面部皮瓣
Ann Plast Surg. 2009 Feb;62(2):149-53. doi: 10.1097/SAP.0b013e31819354f5.