Reconstrucción de partes blandas faciales con colgajos cervicales. Presentación de dos casos / Reconstruction of facial soft parts with cervical flaps. Two cases presentation

La reconstrucción de importantes defectos de partes blandas en la región órbito-maxilo-malar continúa siendo un gran reto para el cirujano. En cirugía reconstructiva, por su parte, hay que abordar dos problemas fundamentales: la recuperación estética y la funcional. Por supuesto que ni el criterio estético ni funcional debe anteponerse al oncológico. En este trabajo se presentaron dos pacientes operados de carcinoma de la glándula parótida, reconstruidos con colgajos cervicales. El primero, con el cérvico-pectoral, y el segundo, con el fascio-cérvico-pectoral. Estos colgajos deberían ser considerados como una de las primeras opciones para reconstruir los defectos en la región maxilofacial, dado su predictibilidad, versatilidad y fácil disección.

The reconstruction of important defects of soft parts in the orbital-maxillary-malar region is still a great challenge for the surgeon. Thus, in reconstructive surgery we have to approach two main problems: esthetic and functional recuperation. Of course, neither the esthetic nor the functional criteria should be placed before the oncological one. In this work we presented the cases of two patients operated of parotid gland carcinoma, reconstructed with cervical flaps; the first one, with the cervico-pectoral flap, and the second with the fascia-cervico-pectoral flap. These flaps should be considered one of the first options for reconstructing the defects of the maxilla-facial region, due to their predictability, versatility and easy dissection.

Reconstrucción de partes blandas faciales con colgajos cervicales. Presentación de dos casos / Reconstruction of facial soft parts with cervical flaps. Two cases presentation

La reconstrucción de importantes defectos de partes blandas en la región órbito-maxilo-malar continúa siendo un gran reto para el cirujano. En cirugía reconstructiva, por su parte, hay que abordar dos problemas fundamentales: la recuperación estética y la funcional. Por supuesto que ni el criterio estético ni funcional debe anteponerse al oncológico. En este trabajo se presentaron dos pacientes operados de carcinoma de la glándula parótida, reconstruidos con colgajos cervicales. El primero, con el cérvico-pectoral, y el segundo, con el fascio-cérvico-pectoral. Estos colgajos deberían ser considerados como una de las primeras opciones para reconstruir los defectos en la región maxilofacial, dado su predictibilidad, versatilidad y fácil disección. (AU)

The reconstruction of important defects of soft parts in the orbital-maxillary-malar region is still a great challenge for the surgeon. Thus, in reconstructive surgery we have to approach two main problems: esthetic and functional recuperation. Of course, neither the esthetic nor the functional criteria should be placed before the oncological one. In this work we presented the cases of two patients operated of parotid gland carcinoma, reconstructed with cervical flaps; the first one, with the cervico-pectoral flap, and the second with the fascia-cervico-pectoral flap. These flaps should be considered one of the first options for reconstructing the defects of the maxilla-facial region, due to their predictability, versatility and easy dissection. (AU)

Total cheek resurfacing with split ascending neck flap: a new approach.

BACKGROUND: Burn scars and other forms of extensive cheek deformities are a tragedy for patients and pose a great challenge to surgeons due to limited availability of well-matching donor sites. The skin of distant regions and skin transplants contrasts with the facial skin. The most suitable site for tissue in cheek reconstruction is the neck, but this resource is limited. Cervical skin expansion is often complicated by tissue necrosis. A new approach (technique) for resurfacing the scarred cheek with a split cervical flap is presented in this paper. METHODS: Sixteen patients with extensive (covering more than half the area) cheek deformities (10 unilateral and 6 bilateral) were operated upon; ages ranged from 6 to 32 years old. First, the split neck flap is transposed on the cheek/cheeks, restoring the lower half; after stabilization of transferred tissues, the cervical flap on the cheeks undergoes balloon extension. Second, the cheek reconstruction is finished with an expanded neck flap. RESULTS: Axial flap circulation prevented tissue necrosis after the first stage of reconstruction. The cervical flap on the cheek tolerated the expander well. In all cases, the cheeks were resurfaced in full with optimally matching sensate skin posing no serious post-operative complications. Cervical skin on the face preserved its natural properties without soft tissue excess and donor site morbidity; neck and cheeks preserved normal contours. CONCLUSION: Good cosmetic outcomes make this technique preferable for adults and children, and the technique is indicated as the first step for deformed cheek resurfacing for patients with uninjured neck.