입체적 유리 광배근피판을 이용한 복합 안면 결손의 재건

Abstract

The difficulty in early detection of maxillary cancer often requires wide resection involving the maxillary sinus, orbit and even the cheek area. Postoperative complications such as oronasal fistula, velopharyngeal insufficiency and facial deformity cause feeding difficulty, loss of vision and speech handicaps. In the past a variety of methods such as skin graft, prosthesis and local flap were used to correct the facial defects following radical maxillectomy. But recently free flap surgery is establishing itself as the accepted trend. Free flaps provide adequate volume mass and is particularly useful in cases where previous surgery or radiotherapy render local flaps infeasible. The authors designed a 3-dimensionally folded latissimus dorsi myocutaneous free flap consisting of nasal cavity, cheek and palatal surface with remaining portions deepithelized. The L-D flap offers the advantage of both adequate pedicle length and sufficient tissue for the volume replacement required in complex facial defects, allowing one stage reconstruction of both nasal and palatal defects. We review in this article 5 cases where free flap reconstruction using the L-D flap was successful and yielded satisfactory results.