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新额头，新自信：癌症切除术后皮瓣推进术

New Forehead, New Confidence: Flap Advancement Post-cancer Excision.

作者信息

Ramesh Gowthaam, R Manimaran, Yesuvadiyan Jesu Pencilin, Selvaraj Karthikeyan, C Srinivasan

机构信息

General Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

Plastic Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.

出版信息

Cureus. 2025 Mar 30;17(3):e81458. doi: 10.7759/cureus.81458. eCollection 2025 Mar.

DOI:10.7759/cureus.81458
PMID:40303544
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12038869/
Abstract

Basal cell carcinoma (BCC) often affects sun-exposed regions, such as the forehead. Surgical excision with histopathologically confirmed clear margins remains the gold standard for treating BCC, especially for high-risk or recurrent cases. Wide local excision ensures complete tumor removal while minimizing the risk of recurrence. However, reconstructing defects in the forehead poses unique challenges due to limited excess skin, high tension, and the presence of muscles. Reconstruction strategies must prioritize preserving functional and cosmetic outcomes, including motor and sensory nerve integrity, and maintaining proper camouflaging incision lines and eyebrow position in relaxed skin tension lines (RSTLs). For large defects, a combination of multiple local tissue flaps is often favored over skin grafting, as it restores facial contours with adjacent, similar tissue and yields higher success rates with fewer complications. This report discusses a case of wide local excision of a BCC over the forehead, followed by defect reconstruction using advancement flaps from the temporal regions.

摘要

基底细胞癌（BCC）常累及暴露于阳光下的部位，如前额。手术切除并经组织病理学证实切缘阴性仍是治疗BCC的金标准，尤其是对于高危或复发病例。广泛局部切除可确保肿瘤完全切除，同时将复发风险降至最低。然而，由于前额皮肤多余量有限、张力高且存在肌肉，修复前额缺损带来了独特的挑战。重建策略必须优先考虑保留功能和美容效果，包括运动和感觉神经的完整性，并在皮肤松弛张力线（RSTL）中保持适当的隐蔽切口线和眉毛位置。对于大面积缺损，多种局部组织瓣联合应用通常比植皮更受青睐，因为它能利用相邻的相似组织恢复面部轮廓，成功率更高且并发症更少。本报告讨论了1例前额BCC广泛局部切除病例，随后采用颞部推进皮瓣进行缺损修复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/2843d1dbc04d/cureus-0017-00000081458-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/8e290d38ad21/cureus-0017-00000081458-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/6a8ff24ff7d1/cureus-0017-00000081458-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/1a15083f8f18/cureus-0017-00000081458-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/f29ab177fa20/cureus-0017-00000081458-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/6e618f152e0f/cureus-0017-00000081458-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/dd763f04ae50/cureus-0017-00000081458-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/8b4c9ff36b67/cureus-0017-00000081458-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/2843d1dbc04d/cureus-0017-00000081458-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/8e290d38ad21/cureus-0017-00000081458-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/6a8ff24ff7d1/cureus-0017-00000081458-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/1a15083f8f18/cureus-0017-00000081458-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/f29ab177fa20/cureus-0017-00000081458-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/6e618f152e0f/cureus-0017-00000081458-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/dd763f04ae50/cureus-0017-00000081458-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/8b4c9ff36b67/cureus-0017-00000081458-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/843b/12038869/2843d1dbc04d/cureus-0017-00000081458-i08.jpg

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本文引用的文献

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Plast Surg (Oakv). 2022 Feb;30(1):68-75. doi: 10.1177/2292550320933663. Epub 2020 Jul 16.
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The incidence and clinical analysis of non-melanoma skin cancer.非黑色素瘤皮肤癌的发病情况与临床分析。
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Electrochemotherapy and basal cell carcinomas: First-time appraisal of the efficacy of electrochemotherapy on survivorship using FACE-Q.
电化学疗法与基底细胞癌：首次使用面部结局质量问卷（FACE-Q）对电化学疗法对生存率的疗效进行评估
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Forehead reconstruction.前额重建。
Dermatol Clin. 2005 Jan;23(1):1-11, v. doi: 10.1016/j.det.2004.09.010.