BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histologi...BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.展开更多
Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radi...Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radial forearm free flaps(RFFF)as a superb method of re-establishing integrity in anterior skull base defects.Methods:Literature review and retrospective analysis of 4 single-institution cases of anterior skull base defects reconstructed with a RFFF.Data were collected on successful and unsuccessful defect repairs,complication rates,and length of hospitalization.Results:The indications for surgery were pneumocephalus,recurrent brain abscesses,recurrent frontal sinus mucoceles,and cerebrospinal fluid leak.Of the 4 cases,1 was complicated by a small dehiscence of the craniotomy site,1 developed infection,and 2 required further surgery.Conclusion:The use of RFFF is an excellent option for reconstruction of defects in the anterior skull base,especially those complicated by radiation,prior surgery,or infections.Patients with skull base defects are inherently at high risk for post-surgical complications.The RFFF transfers healthy,viable,well-vascularized tissue to prevent further infections and provides a reliable barrier between the dural and sinonasal spaces.This can reduce the need for repeat neurosurgical operations and hospitalizations.展开更多
Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of con...Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.展开更多
文摘BACKGROUND Microcystic adnexal carcinoma(MAC)is a rare malignant tumor of the skin that is commonly found on the face.It grows slowly and has a low mortality rate.However,for various reasons,including strong histological invasiveness,clinical inexperience and inadequate procedure design,immediate or permanent facial deformity may occur after surgical operations.CASE SUMMARY This article describes a middle-aged female artist who was diagnosed with MAC on the left upper lip.She declined the recommended treatment plan,which included two-stage reconstruction,skin grafting,or surgery that could have resulted in obvious facial dysfunction or esthetic deformity.We accurately designed a personalized procedure involving a“jigsaw puzzle advancement flap”for the patient based on the lesion location and the estimated area of skin loss.The procedure was successful;both pathological R0 resection and immediate and long-term esthetic reconstruction effects were achieved.CONCLUSION This study suggests that when treating facial MAC or other skin malignancies,a surgical team should have sufficient plastic surgery-related knowledge and skills.An optimal surgical plan for an individual is needed to achieve good facial esthetics and functional recovery and shorten the treatment course.
文摘Aim:Reconstruction of the anterior skull base offers an especially complex challenge as the impermeable separation of the dural space and the upper aerodigestive tract must be maintained.We propose the use of the radial forearm free flaps(RFFF)as a superb method of re-establishing integrity in anterior skull base defects.Methods:Literature review and retrospective analysis of 4 single-institution cases of anterior skull base defects reconstructed with a RFFF.Data were collected on successful and unsuccessful defect repairs,complication rates,and length of hospitalization.Results:The indications for surgery were pneumocephalus,recurrent brain abscesses,recurrent frontal sinus mucoceles,and cerebrospinal fluid leak.Of the 4 cases,1 was complicated by a small dehiscence of the craniotomy site,1 developed infection,and 2 required further surgery.Conclusion:The use of RFFF is an excellent option for reconstruction of defects in the anterior skull base,especially those complicated by radiation,prior surgery,or infections.Patients with skull base defects are inherently at high risk for post-surgical complications.The RFFF transfers healthy,viable,well-vascularized tissue to prevent further infections and provides a reliable barrier between the dural and sinonasal spaces.This can reduce the need for repeat neurosurgical operations and hospitalizations.
文摘Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.
