Zhang Zixuan, Dai Xinyue, Zang Mengqing, Zhu Shan, Li Shanshan, Chen Zixiang, Jin Shengyang, Liu Yuanbo
Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Shijingshan District, Beijing, China.
J Craniofac Surg. 2025 Sep 1;36(6):2093-2097. doi: 10.1097/SCS.0000000000011099. Epub 2025 Jan 31.
The expanded forehead flap based on the frontal branch of the superficial temporal artery (STA-Fbr) is a versatile technique for reconstructing cervicofacial defects. The aim of this study was to summarize STA-Fbr forehead flap harvesting patterns. Between July 2003 and July 2023, 66 patients (43 males) underwent face and neck defect reconstruction using STA-Fbr-based forehead flaps. These were divided into pattern I (vascular-pedicled) and pattern II (cutaneous-pedicled) flaps. Pattern II was subdivided into unilateral (IIa) and bilateral (IIb) cutaneous-pedicled flaps. Pattern IIa flaps were categorized as traditional or scarless based on pedicle location. Of the 66 flaps, 62 survived without perfusion-related complications. There were 10 Pattern I and 56 pattern II flaps (11 traditional IIa, 19 scarless IIa, and 26 IIb). Venous congestion occurred in 3 pattern I and 1 scarless IIa flap. After conservative management, 3 flaps survived; 1 pattern I flap developed distal necrosis. Defects were located in the temporal region, eyebrow, eyelid, nose, cheek, ear, mentum, and neck. Expanders ranged from 50 to 400 mL (average: 236 mL), with expansion times of 3 to 16 months (average: 5.9 mo). Defect dimensions ranged from 3 × 2 cm to 27 × 8 cm (average: 10.8 × 5.3 cm), and flap dimensions ranged from 4 × 3 cm to 30 × 9 cm (average: 16.3 × 6.6 cm). The STA-Fbr-based forehead flap remains a reliable and effective option for cervicofacial defect reconstruction, delivering functional and aesthetic outcomes. Successful surgery requires thorough anatomical knowledge, meticulous flap design, and in-depth patient communication.
基于颞浅动脉额支的扩张额部皮瓣（STA - Fbr）是一种用于修复面颈部缺损的多功能技术。本研究的目的是总结STA - Fbr额部皮瓣的切取方式。2003年7月至2023年7月期间，66例患者（43例男性）使用基于STA - Fbr的额部皮瓣进行了面颈部缺损修复。这些皮瓣分为I型（血管蒂）和II型（皮蒂）皮瓣。II型又细分为单侧（IIa）和双侧（IIb）皮蒂皮瓣。IIa型皮瓣根据蒂的位置分为传统型或无痕型。66例皮瓣中，62例存活，无灌注相关并发症。有10例I型和56例II型皮瓣（11例传统IIa型、19例无痕IIa型和26例IIb型）。3例I型和1例无痕IIa型皮瓣出现静脉淤血。经过保守处理后，3例皮瓣存活；1例I型皮瓣发生远端坏死。缺损位于颞部、眉毛、眼睑、鼻子、脸颊、耳朵、颏部和颈部。扩张器容量为50至400毫升（平均：236毫升），扩张时间为3至16个月（平均：5.9个月）。缺损尺寸为3×2厘米至27×8厘米（平均：10.8×5.3厘米），皮瓣尺寸为4×3厘米至30×9厘米（平均：16.3×6.6厘米）。基于STA - Fbr的额部皮瓣仍然是面颈部缺损修复的可靠有效选择，能带来功能和美学效果。成功的手术需要全面的解剖知识、精心的皮瓣设计以及与患者深入的沟通。
