Hernández D, Celio J, Lima A, Zanatta JA, Bretón MA

Language: Spanish
References: 15
Page: 23-27
PDF size: 269.75 Kb.

ABSTRACT

Squamous cell carcinoma, basal cell and melanoma are the most severe and destructive tumors of the head and neck. Their treatment is resection and adjuvant therapy; however, for the defect reconstruction, especially the cheek and facial central region, preservation of the aesthetic units is very important functionally and aesthetically. In the Plastic and Reconstructive Surgery Service of the Hospital Juarez de Mexico since 1997 a variant of the Juri and Zilmer flap anterior base with cervical submandibular extension has been used. The surgical technique performed in 16 oncologic patients with squamous cell carcinoma, basal cell carcinoma and melanoma is described, with defect average of 6.6 cm. Major complications were 3 x 3 cm epidermolysis in two cases, 15 mL hematoma in two cases, and surgical wound infection in three cases. The average follow-up was five years, and four recurrences of the tumor appeared. The security of the flap is based on the level of dissection and is an option for defects of up to 10 cm.

REFERENCES

1. Zide BM. Deformities of the lips and cheeks. In: JG McCarthy. Plastic Surgery. Philadelphia: Saunders 1990: 2009-2056.

2. Menick FJ. Facial reconstruction in regional units. Perspect Plast Surg 1999; 8: 104.

3. Menick FJ. Facial reconstruction with local and distant tissue: The interface of aesthetic and reconstructive surgery. Plast Reconstr Surg1998; 162: 1424.

4. Barton FE, Zilmer ME. The cervicofacial flaps in cheek reconstruction: Anatomic and clinical observations. Presented at the Annual Meeting of the American Society of Plastic and Reconstructive Surgeons, Honolulu. October 1982.

5. Stark RB, Kaplan JM. Rotation flaps, neck to cheek. Plast Reconstr Surg 1972; 50: 230.

6. Crow ML, Crow FJ. Resurfacing large cheek defects with rotation flaps from the neck. Plast Reconstr Surg 1976; 58: 196.

7. Garrett WS Jr, Giblin TR, Hoffman GW. Closure of skin defects of the face and neck by rotation and advancement of cervicopectoral flaps. Plast Reconstr Surg 1966; 38: 342.

8. Khouri RK, Ozbek MR, Hruza GJ, Young VL. Facial reconstruction with prefabricated induced expanded (PIE) supraclavicular skin flaps. Plast Reconstr Surg 1995; 95: 1007.

9. Shestak KC, Roth AG, Jones NF, Myers EN. The cervicopectoral rotation flap: A valuable technique for facial reconstruction. Br J Plast Surg 1993; 46: 375.

10. Juri J, Juri C. Cheek reconstruction with advancement rotation flaps. Clin Plast Surg 1981; 8: 223.

11. Hamra ST. Composite rhytidectomy. Plast Reconstr Surg 1992; 90: 1-10.

12. Becker DW Jr. A cervicopectoral rotation flap for cheek coverage. Plast Reconstr Surg 1978; 61: 868.

13. Kroll SS, Reece GP, Robb G, Black J. Deep-plane cervicofacial rotation-advancement flap for reconstruction of large cheek defects. Plast Reconstr Surg 1994; 94: 88.

14. Kaplan I, Goldwyn RM. The versatility of the laterally based cervicofacial flap for cheek repairs. Plast Reconstr Surg 1978; 61: 390.

15. Juri J, Juri C. Advancement and rotation of a large cervicofacial flap for cheek repairs. Plast Reconstr Surg 1979; 64: 692.