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SUB-TOTAL NASAL AND UPPER LIP RECONSTRUCTION BY PREFABRICATING A VASCULARIZED L STRAT WITH A COMPOSITE RADIAL FOREARM FLAP
SUB-TOTAL NASAL AND UPPER LIP RECONSTRUCTION BY PREFABRICATING A VASCULARIZED L STRAT WITH A COMPOSITE RADIAL FOREARM FLAP
Articles >
Head and Neck Surgery
Submitted : 14.01.2016
Accepted : 11.05.2016
Published: 11.05.2016
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Abstract
Although regional flaps are considered the first choice in midfacial and nasal tissue defects, the free radial forearm flap remains one of the superior options in larger defects. In this brief report, we present a unique case of a squamous cell carcinoma tumor originating from the columella and destructing the anterior nasal septum, the interior of the nasal dorsum, and the mid-upper lip. After resecting the lesion, a large composite defect was created. In order to achieve an acceptable functional and esthetic result, the defect was reconstructed with a novel designed free radial forearm flap + L strut bipartite vascularized radial bone. The radial bone was harvested based on two separate pedicles originating from the radial artery and concomitant veins. Afterwards, the bone flap was used to reconstruct the nasal septum, whereas the radial forearm flap was used to reconstruct new columella, nasal dorsum, and mid-upper lip structures in a composite fashion. As a result, the report describes a novel design of the free radial forearm flap and vascularized radial bone used in reconstructing a complex three-dimensional defect in the mid-facial region.
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Keywords:
Vascularized radial bone L-strut
, Radial forearm flap
, Midface
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Özet
Rejyonel flepler orta yüz ve nazal doku defektlerinde ilk tercih olarak kabul edilse de, serbest radyal ön kol flepleri geniş defektlerde öncelikli tercih olmayı sürdürmektedir. Bu yazımızda anterior nazal septumu, anterior nazal dorsumu ve üst-orta dudağı destrükte eden kolumella orijinli skuamöz hücreli karsinom patolojik tanılı tümör olgusunu sunuyoruz. Lezyon çıkartıldıktan sonra büyük kompozit bir lezyon oluştu. Fonksiyonel ve estetik sonuç elde edebilmek için defekt yeni dizayn edilmiş serbest ön kol flep ve iki bölümlü vaskülarize radyal kemik ile rekonstrükte edildi. Radyal kemik radyal arter ve venlerden kaynak alan iki ayrı pedikülden oluşuyor. Kemik flep nazal septumdaki defekti onarmak için, radyal önkol flebi kolumella, nazal dorsum, üst-orta dudaktaki defektlerin rekonstrüksiyonunda kullanıldı. Sonuç olarak bu yazı orta fasyal bölgedeki defektin üç boyutlu onarımında kullanılan serbest radyal ön kol flebi ve vaskülarize radyal kemiğin dizaynını tarif etmektedir.
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Anahtar kelimeler:
Vasülarize L-strut
, Radial ön kol flebi
, Orta yüz
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