Surgical manmgement with free flap in repairing hemifacial atrophy in 19 cases / 中华显微外科杂志

ABSTRACT

Objective To investigate the long-term effect of free flap in repairing hemifacial atrophy.Methods From April,1991 to April,2015,19 cases (5 males and 14 females) aged between 18 and 51 years (mean,26 years) with hemifacial atrophy were treated by free flap.Hemifacial atrophy affected the left side in 8 patients,and the right side in the remaining 11.Fifteen cases only had a hemifacial soft tissue deficit,the other 4 cases were associated with ipsilateral zygoma dysplasia,in which 1 had ipsilateral scar contracture.The latissimus dorsi muscle flap were applied in 12 cases (2 of which anastomose thoracodorsal nerve with the cervical branch of the facial nerve),the scapular flap in 2 cases,the tensor fascia latae dermal flap with dermal fat flap in 3 cases,and with iliac groin composite tissue flap and ilium groin dermal composite tissue flap in 1 case respectively.Among them,14 flaps had their blood vessels anastomosed to the superficial temporal artery and vein,and 5 to the facial artery and vein.All operations were successfuly accomplished and followed-up for 2-21 years.Results All patients had ideal clinical outcomes with significant improvement in facial symmetry and skin color,and no dysfunction happened.Conclusion The long-term effect of surgical management with free flap in repairing hemifacial atrophy is satisfactory.It is an effective method of clinical treatment.