透過您的圖書館登入
IP:3.236.145.110

摘要


Background: Forehead contouring or remodeling is typically performed using traditional open methods, such as a direct transcutaneous or bicoronal incision, or through an endoscopic approach. Through the donor site of the paramedian forehead flap, forehead contouring can be performed simultaneously with flap harvesting. Aim and Objectives: This paper presents the experience of forehead contouring during paramedian flap harvesting with simultaneous reconstructive and cosmetic procedures. Materials and Methods: Between July 2011 and November 2016, 86 patients received a paramedian forehead flap for nasal defect reconstruction. Five of them underwent forehead contouring during forehead flap harvesting. We recorded the patient age, sex, nasal defect etiology, forehead bulge area and size, follow-up duration, and complications. Preoperative, intraoperative, and postoperative images were compared to evaluate the esthetic outcomes. Results: Among the five patients, four were men and one was a woman with mean age 39.8 (29-56) years old. All patients presented with a prominent appearance of the frontal or supraorbital region during the preoperative evaluation. Through the donor site of the forehead flap, the bulge in the forehead bone was contoured and shaved under adequate exposure with direct vision and a wide working space. This saves operative time for contouring and leads to more desirable esthetic outcomes and low incidences of accidental neurovascular injury caused by poor exposure and vision. In addition, wound tension was lowered after forehead contouring, which facilitated primary wound closure and wound healing. No patients had complications during a mean follow-up period of 22.2 (7-46) months. All patients were satisfied with both the reconstructive and esthetic outcomes. Conclusion: Through thoughtful preoperative evaluation and planning, forehead contouring during paramedian forehead flap harvesting can simultaneously achieve reconstructive goals and satisfactory esthetic outcomes.

關鍵字

forehead flap contouring

並列摘要


背景:前額凸起常藉由傳統開放性傷口或內視鏡輔助來磨平或切除,而前額皮瓣常使用來重建鼻部缺陷。在取前額皮瓣的同時,藉由同個傷口,針對前額骨不規則的病人,剛好可以同時進行前額骨的塑形,使前額更平整。目的及目標:本研究為分析同時接受前額皮瓣重建及前額骨塑形的經驗,以期能減低病患手術次數並同時達到重建及增加臉部美觀的雙重目的。方法:本研究為回溯性研究,從2011年07月至2016年11月共86位病人接受前額皮瓣進行鼻部重建,其中五位同時合併前額骨塑形手術,我們以病歷統計了這五位病患的年齡、性別、鼻部缺損部位及病因、前額皮瓣大小、合併手術、前額凸起部位及大小、追蹤時間、併發症,並藉由照片比較術前、術中額骨塑形前後的立即改善、以及術後額部的平整及美觀性。結果:五位同時接受前額皮瓣和前額塑形的病人中,四位為男性一位為女性,平均年齡為39.8歲(29-56)。藉由前額皮瓣的傷口,得以在直視下有兩好的手術視野及器械運作空間,能減少塑型的時間,增加平整性及美觀效果,並減少因手術視野不佳空間狹小而造成的神經傷害,另外由於前額骨塑型能減少前額傷口關閉時的張力,進而能幫助前額皮瓣傷口的直接關閉及減少傷口關閉後的張力。在平均追蹤22.2個月(7-46),所有病人均沒有併發症產生,並且都滿意手術效果。結論:藉由術前完整的評估及術中良好的設計,我們可利用前額皮瓣的傷口同時進行前額骨塑形,同時達到重建的目的及增進美觀的效果。

並列關鍵字

無資料

延伸閱讀