"重新神经支配的锯肌游离皮瓣,实现舌重建的功能性结果:手术技术视频"。

IF 3.2 2区 医学 Q1 SURGERY
Plastic and reconstructive surgery Pub Date : 2024-12-01 Epub Date: 2024-04-02 DOI:10.1097/PRS.0000000000011447
Bertrand Baujat, Nicolas Broustaut, Etienne Dauzier, Marc Tassart, Isabelle Wagner, Sarah Atallah, Alix Marhic
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引用次数: 0

摘要

目前,局部晚期肿瘤切除术后舌头重建的基准是使用游离皮瓣或筋膜瓣,如大腿前外侧皮瓣或前臂游离皮瓣。游离皮瓣或筋膜瓣(如大腿前外侧皮瓣或前臂游离皮瓣)可利用残存的原生舌组织的被动活动性,促进舌的体积重建。舌头重建手术的挑战仍然是如何利用既适应又与原生组织相似的组织,通过足够的容积和优化的活动度实现功能恢复。虽然游离锯肌皮瓣已被描述用于各种适应症,但其在舌重建中的应用仍未得到充分开发。具体来说,在局部晚期肿瘤影响活动舌的病例中,通常是在交界区,没有延伸到口底或舌尖,游离锯肌肌皮瓣已显示出很好的效果。通过连接胸背神经和 XII 神经降支,可实现皮瓣的神经再支配。这种技术有利于功能性舌重建,促进粘膜上皮化和神经再支配的快速发展,进而保留肌肉体积,维持足够的滋养度而不发生纤维化。考虑到这些因素,纯肌锯齿游离皮瓣成为舌重建中一种有价值且有效的替代方法。值得注意的是,现有文献中缺乏针对这一适应症的分步骤手术技术描述。我们通过视频展示了手术技巧,并展示了特农医院(法国巴黎)的手术过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reinnervated Serratus Free Flap for a Functional Outcome in Tongue Reconstruction: A Surgical Technique Video.

Summary: The current benchmark for tongue reconstruction after excision of locally advanced tumors involves the use of free skin or fasciocutaneous flaps, such as the anterolateral thigh flap or forearm free flap. They facilitate the volumetric reconstruction of the tongue, leveraging passive mobility from the remaining native tongue tissue. The challenge in tongue reconstruction surgery remains achieving functional restoration through adequate volume and optimized mobility, using tissue that is both adapted and comparable to native tissue. Although the free serratus muscle flap has been described for various indications, its application in tongue reconstructions remains underexploited. In cases of locally advanced tumors affecting the mobile tongue, typically within the junctional area and without extension to the floor of the mouth or to the tip of the tongue, the serratus free flap has shown positive results. Reinnervation of the flap is achieved connecting the thoracodorsal nerve to the descending branch of the XII nerve. This technique facilitates functional tongue reconstruction, promoting rapid mucosal epithelialization and reinnervation, which, in turn, preserves muscle volume and sustains adequate trophicity without fibrosis. Regarding these considerations, the pure muscle serratus free flap emerges as a valuable and effective alternative in tongue reconstruction. There is a dearth of step-by-step operative technique descriptions for this indication in the literature. The authors present videos demonstrating the surgical technique, showcasing procedures as performed at Tenon Hospital (Paris, France).

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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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