ObjectiveTo investigate the clinical application of the modified bilobed flap in the reconstruction of zygomatic-facial massive defect after resection of skin cancer. Methods Between August 2009 and October 2011, 15 patients with skin cancer in the zygomatic-facial region underwent defect reconstruction using modified bilobed flaps after surgical removal. There were 12 males and 3 females, aged 52-78 years (mean, 64.1 years). The disease duration was 1-14 months (mean, 4.6 months). Among the patients, there were 11 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma; 1 patient had infection and the others had no skin ulceration; and tumor involved the skin layer in all patients. According to TNM staging, 13 cases were rated as T2N0M2 and 2 cases as T3N0M3. The defect size ranged from 4.0 cm × 2.5 cm to 6.5 cm × 4.0 cm after cancer resection. The modified bilobed flaps consisting of pre-auricular flap and post-auricular flap was used to repair the defect after cancer resection. The size ranged from 4.0 cm × 2.5 cm to 6.5 cm × 4.0 cm of the first flap and from 3.0 cm × 2.0 cm to 5.0 cm × 3.0 cm of the second flap. ResultsPartial incision dehiscence occurred in 1 case, and was cured after dressing change; the flaps survived and incision healed primarily in the other cases. Fourteen patients were followed up 12-24 months (mean, 18.7 months). No recurrence was found, and the patients had no obvious face asymmetry or skin scar with normal closure of eyelid and facial nerve function. At last follow-up, the results were very satisfactory in 5 cases, satisfactory in 7 cases, generally satisfactory in 1 case, and dissatisfactory in 1 case. ConclusionThe pre- and post-auricular bilobed flaps could be used to reconstruct the massive defects in the zygomatic-facial region after resection of skin cancer.
Citation：
LING Bin,KeremuAbass,HU Mei,YIN Xiaopeng,HU Lulu,LIN Zhaoquan,GONG Zhongcheng.. RECONSTRUCTION OF ZYGOMATIC-FACIAL MASSIVE DEFECT USING MODIFIED BILOBED FLAP AFTER RESECTION OF SKIN CANCER. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(1): 66-68. doi:
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Song T, Yin N, Li H, et al. Bilobed mucosal flap for correction of secondary lip deformities following cleft lip surgery. J Plast Reconstr Aesthet Surg, 2011, 64(5): 589-594.
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Salgarelli AC, Cangiano A, Sartorelli F, et al. The bilobed flap in skin cancer of the face: our experience on 285 cases. J Craniomaxillofac Surg, 2010, 38(6): 460-464.
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Alves HR, Ishida LC, Ishida LH, et al. A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients. J Plast Reconstr Aesthet Surg, 2012, 6(10): 1350-1356.
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邢新, 薛春雨, 李军辉, 等. 鼻部皮肤肿瘤切除后的创面修复. 中国修复重建外科杂志, 2007, 21(7): 714-717.
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容勇贤, 李水容. 应用局部皮瓣修复面部软组织缺损. 中国美容医学, 2010, 19(4): 482-483.
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Wettstein R, Kalbermatten DF, Rieger U, et al. High magnification assessment improves complete resection of facial tumors. Ann Plast Surg, 2006, 57(5): 517-520.
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Ge NN, Mc Guire JF, Dyson S, et al. Nonmelanoma skin cancer of the head and neck II: surgical treatment and reconstruction. Am J Otolaryngol, 2009, 30(3): 181-192.
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邱蔚六. 口腔颌面部缺损修复重建的现状和展望. 中国修复重建外科杂志, 2005, 19(10): 769-772.
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龚忠诚, 林兆全, 阿地力·莫明, 等. 应用前额皮瓣修复鼻和睑部眶下区基底细胞癌切除术后缺损. 中华医学美学美容杂志, 2010, 16(2): 126-127.
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Netscher DT, Spira M. Basal cell carcinoma: an overview of tumor biology and treatment. Plast Reconstr Surg, 2004, 113(5): 74-94.
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- 1. Fleming ID, Amonette R, Monaghan T, et al. Principles of management of basal and squamous cell carcinoma of the skin. Cancer, 1995, 75(2 Suppl): 699-704.
- 2. Song T, Yin N, Li H, et al. Bilobed mucosal flap for correction of secondary lip deformities following cleft lip surgery. J Plast Reconstr Aesthet Surg, 2011, 64(5): 589-594.
- 3. Salgarelli AC, Cangiano A, Sartorelli F, et al. The bilobed flap in skin cancer of the face: our experience on 285 cases. J Craniomaxillofac Surg, 2010, 38(6): 460-464.
- 4. Alves HR, Ishida LC, Ishida LH, et al. A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients. J Plast Reconstr Aesthet Surg, 2012, 6(10): 1350-1356.
- 5. 邢新, 薛春雨, 李军辉, 等. 鼻部皮肤肿瘤切除后的创面修复. 中国修复重建外科杂志, 2007, 21(7): 714-717.
- 6. 容勇贤, 李水容. 应用局部皮瓣修复面部软组织缺损. 中国美容医学, 2010, 19(4): 482-483.
- 7. Wettstein R, Kalbermatten DF, Rieger U, et al. High magnification assessment improves complete resection of facial tumors. Ann Plast Surg, 2006, 57(5): 517-520.
- 8. Ge NN, Mc Guire JF, Dyson S, et al. Nonmelanoma skin cancer of the head and neck II: surgical treatment and reconstruction. Am J Otolaryngol, 2009, 30(3): 181-192.
- 9. 邱蔚六. 口腔颌面部缺损修复重建的现状和展望. 中国修复重建外科杂志, 2005, 19(10): 769-772.
- 10. 龚忠诚, 林兆全, 阿地力·莫明, 等. 应用前额皮瓣修复鼻和睑部眶下区基底细胞癌切除术后缺损. 中华医学美学美容杂志, 2010, 16(2): 126-127.
- 11. Netscher DT, Spira M. Basal cell carcinoma: an overview of tumor biology and treatment. Plast Reconstr Surg, 2004, 113(5): 74-94.
