전외측대퇴피판을 이용한 구강 재건술
Anterolateral Thigh Flap for Reconstruction of the Oral Cavity : Anatomic Study and Clinical Application
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
구강암 절제술 후의 결손부는 크기에 따라 다양한 피판이 사용될수 있는데 혀나, 협점막, 구개 등에 발생하는 연조직결손부는 유리전완피판(radial forearm free flap)이 가장 많이 사용되어 왔다. 그 이유는 피판의 채취가 쉽고 혈관의 직경이 크고 혈관경의 길이가 길어 성공률이 높기 때문이다. 그러나 피부판을 채취한 전완부에 피부이식을 하여 비심미적인 단점이 있고 최근 구강암 수술도 최소의 수술로써 기능과 심미성을 고려하는 추세로 다른 공여부의 필요성이 대두되었다. 따라서 전외측대퇴피판은 이러한 유리전완피판의 단점을 극복할 수 있으면서 유리전완피판의 장점을 가지는 공여부로 최근 많이 사용되고 있는 추세이다.
Abstract
The anterolateral thigh flap(ALT flap) was originally described in 1984 as a septocutaneous flap based on the descending branch of the lateral circumflex artery. This flap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous flap, or a myocutaneous flap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a two-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because flap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to clarify the vascular anatomy and to assess the suitability of anterolateral thigh flap for oral cavity reconstruction in Koreans. In addition, we used anterolateral thigh free flap for oral cavity reconstruction in 20 oral cancer patients from 2006 to 2011. Through our clinical experience, we discuss a series of practical “pearls and pitfalls”. Our experience has not only given us new flap choice using anterolateral thigh flap in oral cavity reconstruction, but also given us a new possibility on the applicability of chimeric flaps.
참고문헌 (7)
- Choi SW, "An anatomic assessment on perforators of the lateral circumflex femoral artery for anterolateral thigh flap", JOURNAL OF CRANIOFACIAL SURGERY, 18(4), pp.866~871
- Song YG, "The free thigh flap: a new free flap concept based on the septocutaneous artery", British Journal of Plastic Surgery, 37, pp.149~159 (1984)
- Koshima I, "Free anterolateral thigh flaps for reconstruction of head and neck defects", Plastic & Reconstructive Surgery, 92, pp.421~428 (1993)
- Xu DC, "Applied anatomy of the anterolateral femoral flap", Plastic & Reconstructive Surgery, 82, pp.305~310 (1988)
- Kimata Y, "Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases", Plastic & Reconstructive Surgery, 102, pp.1517~1523 (1998)
- Makitie AA, "Head and neck reconstruction with anterolateral thigh flap", Otolaryngology - Head and Neck Surgery, 129, pp.547~555 (2003)
- Wei FC, "Have we found an ideal soft-tissue flap? an experience with 672 anterolateral thigh flaps", Plastic and Reconstructive Surgery, 109, pp.2219~2226 (2002)