상악결손부의 2차적 재건에 있어 유리 혈관화 피판의 적용
Late reconstruction of oncological maxillary defect with microvascular free flap
권태건, 김진수,
소속 상세정보
권태건 ( Kwon Tae-Geon ) - 경북대학교 치의학전문대학원 구강악안면외과학교실
김진수 ( Kim Chin-Soo ) - 경북대학교 치의학전문대학원 구강악안면외과학교실
KMID : 0362720110490090527
Abstract
Microvascular reconstruction of maxillary composite defect after oncologic resection has improved both esthetic and functional aspect of quality of life of the cancer patients. However, a lot of patients had prior surgery with radiation and/or chemotherapy as a part of comprehensive cancer treatment. Sometimes it is nearly impossible to find out adequate recipient vessel for maxillary reconstruction with microvascular anastomosis. Therefore long pedicle of the flap is needed to use distant neck vessels located far from the reconstruction site such as ipsilateral transverse cervical artery or a branch of contralateral external carotid artery. For this reason, although we know the treatment of the choice is osteocutaneous flap, it is difficult to use this flap when we need long pedicle with complex three dimensional osseous defect. Vascular option for these vessel-depleted neck patients can be managed by a soft tissue reconstruction with long vascular pedicle and additional free non-vascularized flap that is rigidly fixed to remaining skeletal structures. For this reason, maxillofacial reconstruction by vascularized soft tissue flap with or without the secondary restoration of maxillary bone with non-vascularized iliac bone can be regarded as one of options for reconstruction of profound maxillofacial composite defect resulted from previous oncological resection with chemo-radiotherapy.
키워드
maxillfoacial reconstruction; free flap; vessel-depleted neck; composite defect
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