Choung P H
Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University, Korea.
J Oral Maxillofac Surg. 1996 May;54(5):559-67; discussion 568. doi: 10.1016/s0278-2391(96)90632-1.
Various designs for previously reported postauricular skin flaps have the disadvantages of being two-stage procedures, providing a limited pedicle, or requiring microvascular anastomoses. To overcome such problems, a new auriculomastoid fasciocutaneous (AMFC) island flap for orofacial reconstruction has been developed. This article presents the technique and reports the clinical results.
A long ipsilateral AMFC island flap pedicled by the parietotemporal fascia and based on the parietal branches of the superficial temporal artery, the occipital artery, and the postauricular artery was designed. Twenty-five of these island flaps were used to reconstruct intraoral or external facial defects.
The fasciocutaneous flap could be extended to reach any orofacial defect as a single or compound design in a one-stage subcutaneous procedure. Compound types of AMFC island flaps, including scalp, parietal bone, or the parietotemporal fascia were performed successfully based on single vessels. The flap has the characteristics of providing thin and pliable skin, a good color match to the face, and restored sensitivity. The donor defect is designed to be closed directly and concealed behind the ear without ear deformity.
This flap is very useful in orofacial reconstruction because the skin quality equals that of the radial forearm flap, without the need for microvascular anastomoses, with many additional advantages and various modifications of design.
先前报道的各种耳后皮瓣设计存在一些缺点，如为两阶段手术、蒂部有限或需要微血管吻合。为克服这些问题，已开发出一种用于口腔颌面重建的新型耳颞筋膜皮岛状瓣（AMFC）。本文介绍该技术并报告临床结果。
设计一种以颞顶筋膜为蒂、基于颞浅动脉顶支、枕动脉和耳后动脉的同侧长AMFC岛状瓣。其中25个岛状瓣用于重建口腔内或面部外部缺损。
在一期皮下手术中，筋膜皮瓣可作为单一或复合设计延伸至任何口腔颌面缺损处。基于单一血管成功实施了包括头皮、顶骨或颞顶筋膜的复合类型AMFC岛状瓣。该皮瓣具有提供薄而柔韧的皮肤、与面部颜色匹配良好以及恢复感觉的特点。供区缺损设计为直接闭合并隐藏于耳后，无耳部畸形。
该皮瓣在口腔颌面重建中非常有用，因为其皮肤质量与桡侧前臂皮瓣相当，无需微血管吻合，还有许多其他优点及多种设计改良。
