二皮弁型大腿皮弁による頭頸部領域の再建 Double Anterior (Anterolateral and Anteromedial) Thigh Flaps for Reconstruction of Head and Neck Defects

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二皮弁型大腿皮弁は,独立した長い血管柄を持つ複数の皮弁を良由に配置できるだけでなく,血管柄付骨弁の連結が可能である.また,2皮弁を3次元的に配置することが可能であるので,術後合併症の防止や外観の修正のための確実で十分な充填を行うことができる.さらに最近では血管走行の変異も解明されつつあり,頭頸部領域の複雑な組織欠損の再建にきわめて有用な皮弁と考える.

Although the anterolateral and anteromedial thigh flaps have such disadvantages as anatomical variations in the lateral circumflex femoral system and its cutaneous perforators, they have a sufficient number of cutaneous perforators on the anterior aspect of the thigh in many cases, meaning double anterior thigh flaps can be elevated from the ipsilateral thigh.<br>We report 8 cases in which single-pedicle double anterior thigh flaps were transferred for reconstruction of head and neck defects following resection of head and neck tumors from January 1995 to March 2001 at Okayama Saiseikai General Hospital.<br>Eight double anterior thigh flaps were classified into the following 3 types by perforator derivation: Type I flaps consisting of double anterolateral thigh flaps with a single vascular source were elevated in 4 cases. Type II flaps consisting of anterolateral thigh flap and anteromedial thigh flap supplied by separate branches from a single vascular source were elevated in 2 cases. Type III flaps, in which two anterior thigh flaps were harvested separately and constructed into a single flap with microvascular anastomosis, were elevated in 2 cases.<br>Double anterior thigh flaps were combined with vascularized bone, and 2 flaps supplied by independent long vascular pedicles from a single vascular source could be 3-dimensionally arranged. All flaps completely survived in 7 cases and functionally and aesthetically acceptable results were obtained except in 1 case whose flap was lost to major necrosis after infection.<br>We concluded that the single-pedicle double-flap technique using anterior thigh flaps is useful in 3-dimensional reconstruction of massive complex head and neck defects since sufficient tissue implant with preserved blood flow and free flap arrangement is made available.

収録刊行物

  • 日本耳鼻咽喉科學會會報

    日本耳鼻咽喉科學會會報 107(6), "107-645"-"107-652", 2004-06-20

    一般社団法人 日本耳鼻咽喉科学会

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各種コード

  • NII論文ID(NAID)
    10013293765
  • NII書誌ID(NCID)
    AN00191551
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00306622
  • データ提供元
    CJP書誌  J-STAGE 
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