游离组织瓣修复半侧颜面萎缩19例  

Surgical manmgement with free flap in repairing hemifacial atrophy in 19 cases

作　　者：伍成奇[1] 谢锋[1] 谢振军 李昊[1] 翟弘峰[1] 赵国红 王凯[1] Wu Chengqi;Xie Feng;Xie Zhenjun;Li Hao;Zhai Hongfeng;Zhao Guohong;Wang Kai(Department of Plastic Surgery, He ＂nan Provincial Peo- ple ＂s Hospital, Zhengzhou 450003,Chin)

机构地区：[1]河南省人民医院整形外科,郑州450003 [2]手外科与创伤显微外科

出　　处：《中华显微外科杂志》2018年第2期142-144,共3页Chinese Journal of Microsurgery

摘　　要：目的探讨游离组织瓣修复半侧颜面萎缩的远期疗效．方法1991年4月至2015年4月，采用游离组织瓣修复半侧颜面萎缩19例，男5例，女14例；年龄18～51岁，平均26岁；左侧8例，右侧11例；单纯软组织萎缩15例．软组织萎缩伴同侧颧骨发育不良3例，患侧皮肤瘢痕挛缩、软组织萎缩及颧骨发育不良1例。单纯应用背阔肌肌瓣修复12例（其中2例胸背神经与面神经颈支吻合），应用肩胛筋膜瓣修复2例，应用阔筋膜张肌真皮瓣加真皮脂肪瓣3例．应用髂腹股沟复合组织瓣及髂腹股沟真皮复合组织瓣各修复l例，患侧受区血管取颞浅动、静脉14例．取面动脉及面前静脉5例。手术全部成功，通过门诊随诊和家访随诊方式随访2-21年．结果本组19例患侧无论骨性轮廓或软组织丰满度与健侧基本对称．且患侧面部肤色亦与健侧基本一致，外观满意，面部功能无异常。结论游离组织瓣修复半侧颜面萎缩远期疗效满意．是临床上治疗的一种有效方法。Objective To investigate the long-term effect of free flap in repairing hemifacial atrophy. Meth- ods From April, 1991 to April, 2015, 19 cases （5 males and 14 females） aged between 18 and 51 years （mean, 26 years） with hemifacial atrophy were treated by free flap. Hemifaeial atrophy affected the left side in 8 patients, and the right side in the remaining 11. Fifteen cases only had a hemifacial soft tissue deficit, the other 4 cases were associated with ipsilateral zygoma dysplasia, in which 1 had ipsilateral scar contracture. The latissimus dorsi muscle flap were applied in 12 cases （2 of which anastomose thoracodorsal nerve with the cervical branch of the facial nerve）, the scapular flap in 2 cases, the tensor fascia latae dermal flap with dermal fat flap in 3 cases, and with iliac groin com- posite tissue flap and ilium groin dermal composite tissue flap in 1 case respectively. Among them, 14 flaps had their blood vessels anastomosed to the superficial temporal artery and vein, and 5 to the facial artery and vein. All opera- tions were successfuly accomplished and followed-up for 2-21 years. Results All patients had ideal clinical out- comes with significant improvement in facial symmetry and skin color, and no dysfunction happened. Conclusion The long-term effect of surgical management with free flap in repairing hemifacial atrophy is satisfactory. It is an ef- fective method of clinical treatment.

关 键 词：半侧颜面萎缩 游离组织瓣 显微外科手术 

分 类 号：R622[医药卫生—整形外科]