眼轮匝肌蒂颞区皮瓣修复中面部软组织缺损.docVIP

眼轮匝肌蒂颞区皮瓣修复中面部软组织缺损[摘要]目的：探讨应用眼轮匝肌蒂颞区皮瓣修复中面部小面积软组织缺损（包括眼睑、鼻部及邻近颜面部缺损）的方法及效果。方法：2004年～2010年应用眼轮匝肌蒂颞区皮瓣修复中面部缺损25例,其中鼻尖鼻翼缺损4例,鼻背缺损3例,下睑缺损9例,上睑缺损5例,邻近颜面部缺损4例。结果：1例转移至鼻尖部的皮瓣远端出现坏死,经换药后创面愈合,其余皮瓣完全存合;随访4个月～5年，受区功能形态恢复满意,供区瘢痕不明显，无面神经额支损伤,无眼睑闭合不全,无下睑退缩、外翻等并发症发生。结论：眼轮匝肌蒂颞区皮瓣厚薄适宜，蒂较长，转移灵活，供区隐蔽，是修复中面部小面积缺损的一种较为理想的皮瓣。 [关键词]眼轮匝肌；皮瓣；中面部；缺损 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）01-0001-03 Temporal flaps pedicled with the orbicularis oculi muscle for reconstruction of midfacial soft tissue defects LIU Xiao-rong,LIU Yu-sheng,CHEN Ke-qiong,GAO Yan,HUANG Wei-long,LI De-yan,ZHANG Xiao-ling (Department of Cosmetic and Plastic Surgery,Dongguan People,s Hospital,Dongguan 523018,Guangdong,China) Abstract:ObjectiveTo investigate into the methods and effects of small-sized soft tissue defects of midface,nose and eyelid reconstructed with the temporal flaps pedicled with the orbicularis oculi muscle.MethodsFrom 2004 to 2010, reconstruction with the temporal flaps pedicled with the orbicularis oculi muscle was performed on 25 patients with defects in the midface area,including 4 patients with nasal tip and alae defects,3 patients with nasal dorsum defects,9 patients with lower eyelid defects,5 patients with upper eyelid defects and 4 patients with facial defects ofthe midface.ResultsAll the flaps survived completely except of one flap for reconstruction of nasal tip defect.The distal part of the flap became necrosed because of venous insufficency.The wound eventually healed after dressing changes.Fllow-up ranged from 4 months to 5 years.The recipient site recovered with normal contour and good function.At the donor site, the postoperative scar was inconspicuous and no complication such as injury of the frontal branch of facial nerve,difficulty with eyelid closure,lower lid retraction and ectropion occured.ConclusionThe authors believe that this flap is a good alternative for reconstruction of small-sized defect of the midface due to its advantages,namely, better thickness ma