游离背阔肌肌瓣联合自体脂肪填充序列治疗修复半侧颜面萎缩

Reconstruction of hemifacial atrophy using free latissimus dorsi muscular flap and injected autologous fat transplantation

目的:探讨游离背阔肌肌瓣联合自体脂肪填充序列治疗修复半侧颜面萎缩的效果。方法:对9例半侧颜面萎缩患者,采用I期行游离背阔肌肌瓣移植,于术后0.5～1年行Ⅱ期自体脂肪填充术。根据面部对称情况行1～3次自体脂肪填充,观察其临床效果。结果:9例肌瓣全部成活,术后0.5～1年观察肌瓣轻度下垂,可见局限性凹陷。经1-3次自体脂肪填充后面部外观明显改善,对称性良好,供区无明显功能障碍。结论:游离背阔肌肌瓣联合自体脂肪填充序列治疗是矫治中、重度半侧颜面萎缩的较好选择,结合不同手术特点的综合治疗,能够显著提高中、重度半侧颜面萎缩的治疗效果。

Objective To investigate the effect of free latissimus domi muscular flap and injected autologous fat transplantation in reconstruction of hemifacial atrophy. Methods 9 patients with hemifacial atrophy were treated with free latissimus domi muscular flap at first stage. Then injected autologous fat transplantation was applied in the second stage after 6 to 12 months. Once to three times atuologous fat filling was applied according to the operation effect, and the clinic effects were observed. Results 9 flaps survived completely. Mild ptosis of muscular flap was observed after 6 to 12 months. Local depression was visible either. Facial appearance was improved obviously after one to three times of autologous fat transplantation. No obvious dysfunction was showed in donor site. Conclusion Combined application of free latissimus domi muscular flap and injected autologous fat transplantation is the best option for moderate and severe hemifacial atrophy. Comprehensive therapy combined with characteristics of the different operations can improve the treatment efficacy on moderate and severe hemifacial atrophy.