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題名 | Using Deep Inferior Epigastric Perforator Flap for Hemifacial Atrophy (Parry-Romberg Syndrome) Reconstruction--A Case Report=以深下腹動脈穿通枝皮瓣重建進行性半側臉部萎縮(帕-羅二氏綜合症候群)--病例報告 |
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作者姓名(中文) | 林奕伶; 陳伊呈; 陳彥瑋; 賴志昇; 呂俊德; 顏榮信; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷期 | 27:2 2018.06[民107.06] |
頁次 | 頁141-152 |
分類號 | 416.955 |
關鍵詞 | 深下腹動脈穿通枝皮瓣; 帕羅二氏綜合症候群; 臉部萎縮; Hemifacial atrophy; Deep inferior epigastric perforator flap; DIEP flap; Parry-Romberg syndrome; Fat grafting; |
語文 | 英文(English) |
中文摘要 | 背景:帕羅二氏綜合症候群為一罕見影響半側臉部皮下組織之疾病。為重建臉部凹陷及達到臉部對稱之目的,目前已有許多病例報告及研究討論此疾病之最佳治療手術方式。常見治療方式包括脂肪移植、局部區域皮瓣及自由皮瓣。目的及目標:本研究旨在討論重建帕羅二氏綜合症候群之最佳重建方式且同時避免產生其他併發症或需進行較大的修正手術。另文獻回顧發現部分醫師傾向在疾病進展至穩定狀態前即開始進行重建,故我們也能希望以實證證明有無提早手術可以達到更佳手術結果或是降低疾病進展程度的證據。材料及方法:27歲男性之疾病嚴重度為中度程度(指有肌肉組織的侵犯但無骨組織之侵犯),其接受以深下腹動脈穿通枝皮瓣、後續的脂肪移植及脂肪雕塑重建右側臉部萎縮之重建手術。結果:經過階段性重建手術後,患者臉部萎縮得到足夠的容量重建並可達到理想的對稱。患者術後在腹側及臉部除輕微疤痕增生外均無併發症。病人術後亦無腹部無力、腹部突出或疝氣等狀況。結論:對帕羅二氏綜合症候群患者深下腹動脈穿通枝皮瓣可提供一優秀的治療選擇,搭配術後的脂肪移植及脂肪雕塑,可在不造成其他併發症狀況下達到良好的術後臉部對稱。 |
英文摘要 | Background: Parry-Romberg syndrome is a rare condition that involves the subcutaneous tissue of one side of the face. Many case reports and studies have discussed the optimal solution for reconstruction of depressed facial tissue to achieve more favorable symmetry of patients' faces. The treatment options include fat grafting as well as locoregional flaps and free flaps. Aim and Objectives: The present study investigated the optimal solution for reconstruction in patients with Parry-Romberg syndrome to achieve optimal facial symmetry and prevent complications or major revision surgery. Previous authors have attempted surgical interventions before the disease developed to its final stable stages. We sought to determine whether more favorable results are the outcome when reconstruction commences early. Material and Methods: A 27-year-old man with moderate-grade Parry-Romberg syndrome (i.e., with muscle involvement but without bone involvement) underwent facial reconstruction surgery with a deep inferior epigastric artery perforator flap, concurrent fat grafting and liposculpture to restore the diseased side of the face's soft tissue and regain facial symmetry. Results: After several surgical procedures, substantial facial symmetry was obtained with adequate soft tissue volume on the diseased side of the patient's face. No major complications affected either the donor and recipient sites, except for a mild hypertrophic scar on the lower abdomen. The patient did not complain about abdominal wall weakness, bulging, or hernia from the donor site and was satisfied with the result of reconstruction. Conclusion: A deep inferior epigastric perforator flap may be a promising treatment option for Parry-Romberg syndrome reconstruction. With concurrent liposculpture, substantial facial symmetry can be achieved without development of donor site morbidity. |
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