Lech Dominika, Matysek Jeremi, Maksymowicz Robert, Strączek Cyprian, Marguła Robert, Krakowczyk Łukasz, Kozakiewicz Marcin, Dowgierd Krzysztof
Department of Clinical Pediatrics, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury, Żołnierska 18a Street, 10-561 Olsztyn, Poland.
Oncological and Reconstructive Surgery Clinic, Branch of National Oncological Institute in Gliwice, Maria Sklodowska-Curie Institute-Oncology Centre (MSCI), Ul. Wybrzeze Armii Krajowej 15, 44-100 Gliwice, Poland.
J Clin Med. 2024 Mar 30;13(7):2015. doi: 10.3390/jcm13072015.
: Maxillofacial microvascular free-flap reconstructions are significant interventions in the management of congenital defects, traumatic injuries, malignancies, and iatrogenic complications in pediatric and young adult patients. Craniofacial disorders within this demographic can result in profound functional, cosmetic, and psychosocial impairments, highlighting the critical need for thorough investigation into factors that may influence procedural success and postoperative quality of life. This retrospective chart review aims to examine the outcomes and potential influencing factors, aiming to offer valuable insights into optimizing the effectiveness of these reconstructions and improving patient outcomes. : A single head and neck surgical team performed all the included 136 procedures. Demographic and surgical patient data were recorded. Type of transfer performed in each recipient site and major complications were analyzed. Relevant influencing factors, such as age, gender, and etiology of defect were determined using the ANOVA test and χ test of independence. : The results indicate a 90% success rate. No significant relationship was found between the incidence of total flap loss and patient age, etiology, or graft source. The maxillary reconstructions showed a higher incidence of total flap loss compared to mandibular reconstructions (11 vs. 3 cases). : Despite the high success rate, the findings underline the necessity for further research to validate these observations and enhance surgical methods for pediatric and young adult patients.
颌面微血管游离皮瓣重建术是治疗小儿及青年患者先天性缺陷、创伤性损伤、恶性肿瘤及医源性并发症的重要干预手段。这一人群中的颅面疾病可导致严重的功能、美容和心理社会障碍，凸显了深入研究可能影响手术成功率和术后生活质量的因素的迫切需求。本回顾性病历审查旨在检查结果及潜在影响因素，以期为优化这些重建手术的效果和改善患者预后提供有价值的见解。：一个头颈外科团队实施了所有纳入的136例手术。记录了患者的人口统计学和手术数据。分析了每个受区所进行的转移类型和主要并发症。使用方差分析和独立性χ检验确定相关影响因素，如年龄、性别和缺损病因。：结果显示成功率为90%。皮瓣完全坏死的发生率与患者年龄、病因或移植物来源之间未发现显著关系。与下颌骨重建相比，上颌骨重建的皮瓣完全坏死发生率更高（分别为11例和3例）。：尽管成功率很高，但研究结果强调有必要进一步开展研究以验证这些观察结果，并改进针对小儿及青年患者的手术方法。
