RESUMO
The transverse rectus abdominis musculocutaneous (TRAM) flap based on the deep inferior epigastric artery is useful in head and neck reconstruction as it provides substantial skin and soft tissue cover, and allows volume to be replaced in large defects. A major advantage is the anatomical reliability of the deep inferior epigastric pedicle. We report a case in which neither rectus abdominis muscles had a blood supply from the deep inferior epigastric artery, which necessitated a change in the planned reconstruction. We review variations in the anatomical course of the artery and, although rare, stress the importance of reconstructive surgeons being aware of such variations.
Assuntos
Artérias Epigástricas/anatomia & histologia , Neoplasias Mandibulares/cirurgia , Osteossarcoma/cirurgia , Reto do Abdome/irrigação sanguínea , Retalhos Cirúrgicos/irrigação sanguínea , Adulto , Feminino , Humanos , Neoplasias Induzidas por Radiação/cirurgia , Coleta de Tecidos e ÓrgãosRESUMO
UNLABELLED: Dislocation of the temporomandibular joint (TMJ) is rare in children. We present the second youngest case reported. Diagnosis was delayed owing to failure to recognize important clinical signs. We outline how this problem can be recognized and treated, and propose radiographic confirmation of the clinical diagnosis which is not necessary if there is no history of direct mandibular trauma. Two new clinical signs are demonstrated. CLINICAL RELEVANCE: TMJ dislocation is of relevance to all dental professionals because it can occur in the dental chair and because dental professionals are often called upon to manage this condition.
