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放射性半侧面部后遗症的重建技术:一例血管瘤病例研究

Reconstructive techniques for radiation-induced hemifacial sequelae: A hemangioma case study.

作者信息

Sơn Trần Thiết, Nghĩa Phan Tuấn, Dung Phạm Thị Việt, Thuý Tạ Thị Hồng

机构信息

Department of Plastic and Reconstructive Surgery, Hanoi Medical University, No.1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, University of Medicine and Pharmacy, Hanoi National University, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Viet Nam.

Department of Plastic and Reconstructive Surgery, Hanoi Medical University, No.1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam; Department of Plastic Reconstructive and Aesthetic Surgery, Bach Mai Hospital, Hanoi, Viet Nam.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109906. doi: 10.1016/j.ijscr.2024.109906. Epub 2024 Jun 12.

Abstract

INTRODUCTION AND IMPORTANCE

The use of radiation therapy for infantile hemangiomas 30 years ago has led to severe consequences in adulthood.

CASE PRESENTATION

This article shares the experience of using multiple reconstructive procedures to treat radiation-induced hemifacial sequelae for capillary malformations. Based on the damaged anatomical surgical units, appropriate reconstructive materials are used for the surgery. Thin antero-lateral thigh (ALT) flaps cover lesions on the forehead and cheeks, while a skin expander covers the temporal scalp lesion. Autologous grafting covers damage in both eyelids.

CLINICAL DISCUSSION

Choosing a suitable reconstructive material will provide aesthetic outcomes such as facial symmetry, skin color compatibility, and textural similarity in the constructive areas for the patient. The patients were highly satisfied with the surgical results.

CONCLUSION

Using appropriate surgical techniques and materials, along with meticulous attention to facial integrity, can achieve optimal aesthetic and functional outcomes in patients with severe facial disfigurement from radiation therapy. A thorough understanding of pathophysiology and anatomy, along with skillful execution, can result in a successful outcome and improved quality of life.

摘要

引言与重要性

30年前对婴儿血管瘤使用放射治疗已在成年期导致严重后果。

病例介绍

本文分享了使用多种重建手术治疗放射性毛细血管畸形所致半侧面部后遗症的经验。根据受损的解剖手术单元,手术中使用合适的重建材料。股前外侧(ALT)薄皮瓣覆盖前额和脸颊的病变,而皮肤扩张器覆盖颞部头皮病变。自体移植修复双眼睑损伤。

临床讨论

选择合适的重建材料可为患者在重建区域提供诸如面部对称、肤色匹配和质地相似等美学效果。患者对手术结果高度满意。

结论

运用适当的手术技术和材料,同时精心关注面部完整性,对于因放射治疗导致严重面部毁容的患者可实现最佳的美学和功能效果。对病理生理学和解剖学的透彻理解以及熟练的操作可带来成功的结果并改善生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac34/11228589/18e152eb5aaa/gr1.jpg

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