유리 광배근피판을 이용한 안면부 복합재건 치험례

Facial reconstruction using LD-myocutaneous free flaps : report of cases

This is to report a case of Latissimus Dorsi myocutaneous free flaps used to reconstruct the paralyzed cheek defect. The patient who had been sufferred from congenital facial nerve paralysis and accompanied muscular atrophy showing horse-face mask appearance was treated by bilateral LD Neuro-Musculo-Cutaneous free flaps. The clinical applications of LD neuro-muscular free flaps and the results were as follows; 1. Two LD free flaps(15×3cm) with longer vascular stalk (8,10cm in length) were raised and transferred to both cheeks. 2. The thoracodorsal arteries feeding the LD-flaps were as big as 1.5~2.5mm in diameter, and the surgical risk of failure in vascular anastomosis could be very low. 3. Color of the LD-flaps matched good to the facial skin. 4. Muscle flaps containing the motor nerves responsed to nerve stimuli, but the facial expression could not be recovered due to the prolonged degeneration of proximal facial nerve. 5. The complications of donor site were minimal, and the function of arms were recovered soon postoperatively.