UNASSIGNED: Five patients underwent maxillectomy with defects disrupting two or more of the following facial axes: orbital, nasofacial, and palatal axes. Patients underwent primary reconstruction using an angular artery-based scapular tip-free flap with an osteotomy to fold the flap. Harvest techniques, including placement of osteotomies, folding and plating, surgical esthetic, and functional outcomes, are presented.
UNASSIGNED: Osteotomies placed in the scapular tip-free flap allowed folding of the osseous flap and improved restoration of all three facial axes with a single flap. In one patient, the tip of the scapula was used to reconstruct the nasofacial axis, while the body and lateral border were used to reconstruct the palate. In four patients, the tip of the scapula was used to reconstruct the orbital axis, while the body and lateral border were used to reconstruct the nasofacial axis. Patients had successful oronasal separation, healed wounds withstanding adjuvant therapy, satisfactory orbital positioning and facial projection, preserved masticatory surfaces and opportunity for dental implants.
UNASSIGNED: The midface is geometrically complex and is one of the most challenging head and neck sites to reconstruct. Ablative defects in this area can disrupt facial axes resulting in poor esthetic and functional outcomes. This study demonstrates the reconstructive advantages of a novel osteotomized folded scapular tip-free flap.
UNASSIGNED:五名患者接受了上颌骨切除术,其缺陷破坏了以下两个或多个面轴:眼眶,鼻面部,和腭轴。患者使用基于角状动脉的肩胛骨无端皮瓣进行初次重建,并进行截骨术以折叠皮瓣。收获技术,包括截骨术的放置,折叠和电镀,外科美学,和功能结果,被呈现。
UNASSIGNED:放置在无肩胛骨尖端皮瓣中的截骨术可以使骨皮瓣折叠,并使用单个皮瓣改善了所有三个面部轴的恢复。在一个病人中,肩胛骨的尖端被用来重建鼻面轴,而身体和侧边界被用来重建腭。在四名患者中,肩胛骨的尖端被用来重建眶轴,而身体和侧边界被用来重建鼻面部轴。患者的口鼻分离成功,愈合的伤口承受辅助治疗,令人满意的眼眶定位和面部投影,保存的咀嚼表面和牙科植入物的机会。
UNASSIGNED:中面几何形状复杂,是重建头颈部最具挑战性的部位之一。该区域的消融缺陷会破坏面部轴,从而导致不良的美学和功能结果。这项研究证明了新型截骨折叠肩胛骨无端皮瓣的重建优势。