轴型颏下动脉颈阔肌筋膜瓣转移修复下面部静脉畸形硬化治疗后的凹陷

Repair of basifacial depressions induced by sclerotherapy for venous malformations with shifted axis platysma-fascial flap including submental artery

目的探讨轴型颏下动脉颈阔肌筋膜瓣修复下面部静脉畸形硬化治疗后外观凹陷的可行性。方法对15例下面部静脉畸形硬化治疗后的外观凹陷患者进行轴型颏下动脉颈阔肌筋膜瓣转移修复，术前常规行彩色多普勒超声检查、定位，并标记颏下动脉，术中采用患侧颌下顺皮纹隐蔽切口游离下面部凹陷区和供区，切取轴型颏下动脉颈阔肌筋膜瓣修复畸形。术后随访3个月至2年，观察临床效果。结果15例筋膜瓣术后全部成活，填充的凹陷畸形区局部丰满，有弹性，双侧面颈部基本对称．供区无继发凹陷畸形。结论轴型颏下动脉颈阔肌筋膜瓣修复下面部静脉畸形硬化治疗后的外观凹陷，具有手术操作简便、组织供应量大、成活率高、外形好、切口隐蔽的特点，可作为下面部静脉畸形硬化治疗后外观凹陷的首选治疗方法。

Objective To investigate the feasibility of reconditioning post-sclerotherapy basifa- cial depressions for venous malformations with the axis platysma-fascial flap including submental arter- y. Methods Fifteen cases of post-sclerotherapy depressions of venous malformations were treated from Dec. 2008 to Oct. 2013. Preoperative color Doppler ultrasonography was routinely performed to localize and mark sublingualissubmental artery. Upper hind neck incision was made to dissociate de- pressed and donor area, after which reconstruction were performed with axis platysma-fascial flap in- cluding submental artery. 3 months to 2 years＂ follow-ups were conducted to observe clinical effects. Results All the flaps were alive in all the 15 cases. Satisfacfory recovery archeived because the de- pressed area appeared well-stacked wihtout secondary depression in the neck. Conclusions It is rec- ommended that axis platysma-fascial flap should be the first chioce of reconditioning basifacial post- sclerotherapy depressions for venous malformations, as the operations can be peformed easily under concealed incision with abundant tissues supply and high survival rate.