颞浅动脉额支葫芦形皮瓣推进修复颞下区耳前肿瘤切除术后创面

Advanced gourd-shaped flap with frontal branch of superficial temporal artery for defects after resection of per-auricular tumor

目的探讨应用以颞浅动脉额支为蒂的葫芦形皮瓣递进式推进修复颞下区耳前部肿瘤切除术后创面的临床效果。方法2012年6月至2016年9月，收治颞下区耳前部肿瘤患者9例，其中基底细胞癌7例，鳞状细胞癌2例，病程1—6年。肿瘤大小0．5cm×1．0cm-1．0cm×2．0cm，根据肿瘤性质扩大切除肿瘤组织，术中送冰冻病理检查，提示各切缘及基底缘无肿瘤侵犯后，根据创面位置、大小及周边血管穿支情况，设计以颞浅动脉额支为蒂的葫芦形皮瓣递进式推进修复创面，供区直接拉拢缝合，皮瓣面积2．0cm×5．0cm-3．0cm×7．5cm。结果术后9例患者皮瓣存活，无血运障碍，切口愈合良好。随访6-36个月，肿瘤无复发，切口瘢痕不明显，皮瓣色泽与周围皮肤无明显差异，无面瘫和面部皮肤感觉异常现象，外形和功能效果均较满意。结论颞浅动脉额支葫芦形皮瓣血供可靠，递进修复避免局部明显张力的形成，转移灵活，术后外观效果好，是修复颞下区耳前部软组织缺损的理想方法之一。

Objective To investigate the therapeutic effect of advanced gourd-shaped flap with frontal branch of superficial temporal artery for defects after resection of per-auricular tumor. Methods From June 2012 to September 2016, 9 cases with pre-auricular tumor, including 7 cases of basal cell cancer and 2 cases of squamous cell carcinoma, received extended resection operation. The tumor size ranged from 0.5 cm × 1.0 cm to 1.0 cm × 2. 0 cm. Intraoperative frozen specimen was used to make sure no invasion at margin and defect bottom. Based on the size and location of defects, the advanced gourd-shaped flap with frontal branch of superficial temporal arterywas designed to cover the defect. The wounds at donor sites were closed directly. The flap size ranged from 2. 0 cm × 5.0 cm to 3.0 cm × 7. 5 cm. Results The flaps in all the 9 cases survived completely with primary healing and no complication, like facial paralysis or abnormal feeling. The patients were followed up for 6 - 36 months with inconspicuous scarandno tumor relapse. Satisfactory cosmetic and functional result can be achieved. The flaps had good match in color with the surrounding tissue. Conclusions The advanced gourd-shaped flap with frontal branch of superficial temporal arteryhas a reliable blood supply and flexible transverse method with satisfactory cosmetic result. It is one of the ideal method for reconstruction of pre-auricular soft tissue defects.