臂外侧皮瓣修复重度眶窝闭锁畸形  

Reconstruction of severe atresic eye socket with lateral arm free flap

作　　者：祝为桥[1] 李冬梅[2] 刘静明[1] 毛驰[3] 戚戈[1] 

机构地区：[1]首都医科大学附属北京同仁医院口腔科,北京100730 [2]首都医科大学附属北京同仁医院眼科中心,北京100730 [3]北京大学口腔医学院

出　　处：《中华显微外科杂志》2014年第5期461-463,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨臂外侧皮瓣修复重度眶窝闭锁畸形的方法并评价其效果。方法2011年6月至2013年6月，应用臂外侧皮瓣修复重度眶窝闭锁畸形14例，皮瓣制备成6cm×10cm水滴形，修剪部分表皮后以6cm×6cm皮瓣重建眶窝，其余筋膜部分修复颞部塌陷。桡侧副动脉后支同颞浅动脉吻合，后桡侧副静脉同颞浅静脉吻合11例、同颞中静脉吻合3例。结果14例皮瓣完全成活，经局部整形手术后均成功佩戴义眼，经1～3年随访颞部塌陷改善，修复效果较满意且无并发症发生。结论臂外侧皮瓣修复眶窝闭锁畸形具有供区隐蔽、组织量恰当、血管匹配、功能障碍轻以及并发症少的优点，值得推荐。Objective To study the method and effect of lateral arm free flap in reconstruction of severe atresic eye socket. Methods Forteen cases of severe atresic eye socket, from June, 2011 to June, 2013, were repaired by lateral arm free flap. The flaps were designed and harvested as drop shape with size about 6 cm× 10 cm and then were removed epidermis except distal 6 cm × 6 cm area which were transferred to orbit for eye socket reconstruction. The remaining fascia and dermis were filled to augment temporal defect. Superficial temporal artery was anastomosed with posterior branch of radial collateral artery in 14 cases and superficial temporal vein was anstomosed with radial collateral vein in 11 cases, with middle temporal vein in 3 cases. Results All 14 cases lateral arm free flaps survived with no donor site morbidity. Followed up for 1 year to 3 years, artificial eye could be fitted satisfactorily and temporal contour improved. Conclusion Lateral arm free flap is a recommendable option for severe atresic eye socket reconstruction because of concealed donor site scar, proper volume, matched vascular caliber and minor donor site morbidity.

关 键 词：眶窝闭锁 臂外侧皮瓣 桡侧副动脉 显微外科技术 

分 类 号：R622[医药卫生—整形外科]