Miyamoto Shimpei, Arikawa Masaki, Okazaki Mutsumi
Department of Plastic and Reconstructive Surgery, The University of Tokyo.
Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
J Craniofac Surg. 2025;36(1):234-236. doi: 10.1097/SCS.0000000000010768. Epub 2024 Oct 10.
Midface deformities due to oncologic bony defects are often difficult to secondarily correct. The authors herein report 2 cases of secondary reconstruction of an oncological premaxillary defect using a π-shaped fibula osteocutaneous flap. The authors divided the fibula into 3 pieces and made it π-shaped to reconstruct the curvature of the premaxilla. The palatal mucosal defect was closed with a skin paddle. The vascular pedicle was hooked up to the neck vessels either directly or by interposition of vessel grafts. Reconstruction was successful in both cases. The facial appearance was greatly improved, the palatal defects were closed, and the need for obturator prosthetics was eliminated. Immediate bony reconstruction is preferred for premaxilla defects. However, secondary reconstruction with a π-shaped fibula osteocutaneous flap is a feasible option with high potential for improving aesthetic and functional outcomes.
由于肿瘤性骨缺损导致的面中部畸形通常难以进行二期矫正。本文作者报告了2例使用π形腓骨骨皮瓣二期重建肿瘤性前颌骨缺损的病例。作者将腓骨分成3段并使其呈π形，以重建前颌骨的曲度。腭部黏膜缺损用皮瓣封闭。血管蒂直接或通过血管移植与颈部血管相连。两例重建均获成功。面部外观得到极大改善，腭部缺损得以封闭，不再需要阻塞性修复体。前颌骨缺损首选即刻骨重建。然而，用π形腓骨骨皮瓣进行二期重建是一种可行的选择，具有改善美学和功能效果的巨大潜力。
