La Rossa D, Whitaker L, Dabb R, Mellissinos E
Cleft Palate J. 1980 Apr;17(2):138-43.
The extent of facial deformity from hemifacial microsomia varies considerably. Minor degrees of asymmetry may be barely perceptible. Severe defects involve deficiencies and asymmetry of bone and soft tissue. Hence, reconstruction of both soft and hard tissues may be necessary. The authors have utilized a free flap based on the superior gluteal vessels to replace soft tissue deficits in three children with hemifacial microsomia. The flap, composed of fascia lata, adjacent muscle and fat (two patients) and overlying skin (one patient), is harvested through an incision high on the lateral thigh in the "bathing trunk" area. The vessels, measuring 0.5--1.0 mm. were anastomosed to the facial (one patient) and superficial temporal (two patients) vessels. In one child, simultaneous mandibular restructuring was done with bone grafts. The children ranged in age from four to eight years. Follow-up is for five to seven months. Although this microvascular procedure requires a prolonged anesthetic, it permits more accurate and predictable reconstruction. Scars are placed in inconspicuous or concealed areas. Simultaneous bony reconstruction can be done. Details of the procedure and an evaluation of postoperative results are presented.
半侧颜面短小畸形导致的面部畸形程度差异很大。轻微程度的不对称可能几乎难以察觉。严重缺陷涉及骨骼和软组织的缺损及不对称。因此，可能需要对软组织和硬组织都进行重建。作者采用了基于臀上血管的游离皮瓣来修复3例半侧颜面短小畸形患儿的软组织缺损。该皮瓣由阔筋膜、相邻肌肉和脂肪（2例患者）以及覆盖其上的皮肤（1例患者）组成，通过在大腿外侧高位“泳裤区”的切口获取。血管直径为0.5 - 1.0毫米，与面动脉（1例患者）和颞浅动脉（2例患者）进行吻合。在1例患儿中，同时进行了下颌骨重建并植骨。患儿年龄在4至8岁之间。随访时间为5至7个月。尽管这种微血管手术需要较长时间的麻醉，但它能实现更精确和可预测的重建。瘢痕位于不显眼或隐蔽的部位。可以同时进行骨重建。本文介绍了该手术的细节及术后结果评估。
