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[颞浅筋膜在面部重建手术中的应用。附35例报告]

[Fascia superficialis temporalis in facial reconstructive surgery. Apropos of 35 cases].

作者信息

Cariou J L, Payement G, Rochebiliére A, Lambert F, Bellavoir A

机构信息

Service de Chirurgie Plastique, Chirurgie maxillo-faciale et Stomatologie, Hôpital d'Instruction des Armées Bégin, Saint-Mande.

出版信息

Ann Chir Plast Esthet. 1994 Feb;39(1):106-18.

PMID:7864563
Abstract

The fascia superficialis temporalis (FST), one of the planes of cranial cover, can be raised to form an axial pedicle flap or a vascular island flap on superficial temporal vessels. Its fibrovascular structure, the area able to be raised and the possible addition of other superficial tissues (scalp, forehead skin) and deep tissues (calvarial bone) mean that this flap can be used in surgery of the external and intracavitary facial contours and shapes. The authors report their experience of 35 facial reconstructions: 7 ear reconstructions, 5 suspensions of a paralysed labial commissure, 10 conjuctivo-palpebral revisions, repair of 5 subcutaneous defects, 3 haired resurfacings, 1 inferior labial, 1 cheela, 1 orbitomalar reconstruction, 1 malo-commissuro-labial repair, 1 prefabricated free flap. The donor site sequelae were considered to be negligible: 1 case of temporal anaesthesia with dysaesthesiae, 4 cases of band alopecia. The analysis of these 35 reconstructions reveals the quality of all cases of defect repair, especially palpebral; the ease and persistence of suspensions of the labial commissure; the value of FST as a conjunctival and buccal mucosal substitute; the density of the hair contribution. However, total or partial ear reconstruction using this technique constitutes a more limited indication.

摘要

颞浅筋膜(FST)是颅盖的层次之一,可掀起形成以颞浅血管为蒂的轴型皮瓣或血管岛状皮瓣。其纤维血管结构、可掀起的面积以及可能添加的其他浅表组织(头皮、额部皮肤)和深部组织(颅骨)意味着该皮瓣可用于面部外部和腔内轮廓及外形的手术。作者报告了他们在35例面部重建中的经验:7例耳部重建、5例瘫痪唇 commissure 的悬吊、10例结膜-睑板修复、5例皮下缺损修复、3例毛发覆盖修复、1例下唇修复、1例 cheela 修复、1例眶颧重建、1例颧-唇 commissure-唇修复、1例预制游离皮瓣。供区后遗症被认为可忽略不计:1例颞部麻醉伴感觉异常,4例带状脱发。对这35例重建的分析揭示了所有缺损修复病例的质量,尤其是睑部;唇 commissure 悬吊的简便性和持久性;FST作为结膜和颊黏膜替代物的价值;毛发贡献的密度。然而,使用该技术进行全耳或部分耳重建的适应证较为有限。

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