Lee Z-Hye, Canzi Ana, Yu Jessie, Chang Edward I
Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030, USA.
J Clin Med. 2024 Feb 26;13(5):1311. doi: 10.3390/jcm13051311.
The field of microsurgical head and neck reconstruction has witnessed tremendous advancements in recent years. While the historic goals of reconstruction were simply to maximize flap survival, optimizing both aesthetic and functional outcomes has now become the priority. With an increased understanding of perforator anatomy, improved technology in instruments and microscopes, and high flap success rates, the reconstructive microsurgeon can push the envelope in harvesting and designing the ideal flap to aid patients following tumor extirpation. Furthermore, with improvements in cancer treatment leading to improved patient survival and prognosis, it becomes increasingly important to have a broader repertoire of donor sites. The present review aims to provide a review of newly emerging soft tissue flap options in head and neck reconstruction. While certainly a number of bony flap options also exist, the present review will focus on soft tissue flaps that can be harvested reliably from a variety of alternate donor sites. From the upper extremity, the ulnar forearm as well as the lateral arm, and from the lower extremity, the profunda artery perforator, medial sural artery perforator, and superficial circumflex iliac perforator flaps will be discussed, and we will provide details to aid reconstructive microsurgeons in incorporating these alternative flaps into their armamentarium.
近年来，显微外科头颈部重建领域取得了巨大进展。虽然重建的历史目标仅仅是使皮瓣存活率最大化，但如今优化美学和功能效果已成为首要任务。随着对穿支血管解剖结构的认识不断加深、器械和显微镜技术的改进以及皮瓣成功率的提高，重建显微外科医生在获取和设计理想皮瓣以帮助肿瘤切除后的患者方面可以更进一步。此外，随着癌症治疗的改善导致患者生存率和预后的提高，拥有更广泛的供区选择变得越来越重要。本综述旨在对头颈部重建中新兴的软组织皮瓣选择进行综述。虽然确实也存在一些骨皮瓣选择，但本综述将重点关注可从各种替代供区可靠获取的软组织皮瓣。上肢的尺侧前臂皮瓣以及外侧臂皮瓣，下肢的股深动脉穿支皮瓣、腓肠内侧动脉穿支皮瓣和旋髂浅动脉穿支皮瓣将被讨论，并且我们将提供详细信息，以帮助重建显微外科医生将这些替代皮瓣纳入他们的技术储备。
