Brown J S
Regional Centre for Maxillofacial Surgery, Walton Hospital, Liverpool, United Kingdom.
Head Neck. 1996 Sep-Oct;18(5):412-21. doi: 10.1002/(SICI)1097-0347(199609/10)18:5<412::AID-HED4>3.0.CO;2-8.
A wide range of pedicled and free tissue transfer flaps have been described in the reconstruction of the complex maxillofacial defect, but no preferred reconstructive technique has so far emerged. The previous methods described may effectively close the oronasal fistula but reliable support for the cheek and orbit while providing a basis for an implant retained prosthesis is less likely to be achieved.
The methods of using the flap in low, high, and central maxillectomy defects as well as cases requiring orbital exenteration are described.
The deep circumflex iliac artery (DCIA) flap with internal oblique provides a reliable reconstruction for the maxillectomy as the fistula is closed with muscle which becomes epithelialized with minimal bulk. The large volume of bone available from the iliac crest can restore the facial contour, support the orbital contents, reconstruct the orbital rim, and provide sufficient bulk of bone for the placement of implants.
在复杂颌面缺损的重建中，已经描述了多种带蒂和游离组织转移皮瓣，但目前尚未出现首选的重建技术。先前描述的方法可能有效地闭合口鼻瘘，但在为植入式修复体提供基础的同时，不太可能为脸颊和眼眶提供可靠的支撑。
描述了在低位、高位和中央上颌骨切除缺损以及需要眼眶内容物剜除术的病例中使用皮瓣的方法。
带腹内斜肌的旋髂深动脉（DCIA）皮瓣可为上颌骨切除术提供可靠的重建，因为瘘管用肌肉闭合，肌肉上皮化后体积最小。从髂嵴可获得大量骨，可恢复面部轮廓，支撑眼眶内容物，重建眶缘，并为植入物的放置提供足够的骨量。
