RECONSTRUCTION OF COMPLEX MAXILLECTOMY DEFECTS WITH THE SCAPULAR-FREE FLAP
RECONSTRUCTION OF COMPLEX MAXILLECTOMY DEFECTS WITH THE SCAPULAR-FREE FLAP
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DOI：
10.1002/hed.2880120502
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发表时间：
1990-09-01
影响因子：
2.9
通讯作者：
KALTMAN, S
中科院分区：
文献类型：
--
作者：
GRANICK, MS;RAMASASTRY, SS;KALTMAN, S
上颌骨部分或全部切除后造成的缺损，通常可以用皮肤移植和假体重建。在这种简单的操作不能令人满意的情况下，需要一种更复杂的重建方式，提供复合组织的恢复。在这一系列的11例患者中，肩胛骨微血管游离皮瓣，作为皮瓣在3和8作为骨皮瓣，以满足每个病人的具体重建需求。10例患者面部外形和腭功能恢复良好。有1例皮瓣失败。无供体部位并发症。选定的情况下，历史证明重建问题的频谱。其适用性存在明显的局限性，例如肩胛骨的外形不规则、皮桨的厚度、皮瓣获取所需的位置变化以及皮瓣失败的风险。肩胛皮瓣已被证明是有用的，在恢复骨和软组织轮廓的脸，刚性支持帆，口鼻分离，支持眼眶，和闭塞的上颌窦。我们发现肩胛游离皮瓣是一个有用的工具，用于重建复杂和可变的上颌骨切除缺损。
The defect resulting from partial or complete maxillectomy can often be reconstructed with a skin graft and a prosthesis. In situations where this simple maneuver is unsatisfactory, a more complex reconstructive modality, providing the restoration of composite tissue, is required. The scapular microvascular-free flap was used in this series of 11 patients, as a cutaneous flap in 3 and as an osteocutaneous flap in 8, to meet the specific reconstructive needs of each patient. Excellent to satisfactory restoration of facial contour and palatal function was achieved in 10 patients. There was 1 flap failure. There were no donor site complications. Selected case histories are presented to demonstrate a spectrum of reconstructive problems. There are clear limitations to its applicability, such as the odd scapular bone contour, the thickness of the cutaneous paddle, the position change required for flap harvesting, and the risk of flap failure. The scapular flap has proven to be useful in restoring bony and soft tissue contour of the face, rigid support for the velum, oronasal separation, support for the orbit, and obliteration of the maxillary sinus. We found the scapular-free flap to be a useful tool for reconstructing complex and variable maxillectomy defects.