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  • Title: Microsurgical SCIA/SIEA flap for facial contour correction in patient with hemifacial microsomia.
    Author: Battisti A, Cassoni AC, Bartoli D, Monaca MD, Barbera G, Cerbelli E, Valentini V.
    Journal: Ann Ital Chir; 2017; 88():. PubMed ID: 28604380.
    Abstract:
    AIM: We propose our experience in soft tissue reconstruction in Hemifacial microsomia using a free fascioadiposal flap. MATERIAL OF STUDY: Hemifacial microsomia (HFM) is a congenital disorder characterized by craniofacial malformation of one or both sides of the lower face. A 18-year-old female presented with hemifacial microsomia involving the left side. A free SCIA/SIEA fascioadiposal flap was transferred to the left face for soft tissue augmentation. RESULTS: The immediate postoperative course of the patient was uneventful, with no complication and adequate augmentation in contour deformity was achieved. One year after the procedure, the patient presented a good resolution of the deformity with improved facial symmetry DISCUSSION: Reconstruction for facial contour deformities is still a challenging process and treatment for most cases is achieved only by soft tissue augmentation. Several microsurgical flaps have been proposed for restoration of facial asymmetry and improvement of facial volume and contour in these patients: deltopectoral, parascapular, anterolateral thigh, groin and deep inferior epigastric. This article reports our experience in facial soft tissue reconstruction with microsurgical superficial circumflex iliac artery/superficial inferior epigastric artery (SCIA/SIEA) fascioadiposal flap transfer in patient with HFM. This flap, which has a dual blood vascularization and pliant soft tissue, can provide an ideal treatment for soft tissue augmentation in hemifacial microsomia with optimal aesthetic results both in the face and at the donor site. CONCLUSION: The free SCIA/SIEA fascioadiposal flap is a optimal choise option for soft tissue reconstruction with good esthetical outcome both in the face and at the donor site. KEY WORDS: Facial augmentation, Free flaps, Free SCIA/SIEA flap, Hemifacial microsomia. Il trattamento chirurgico delle gravi atrofie dei tessuti molli caratterizzanti la microsomia emifacciale rappresenta attualmente una ardua impresa. In questo articolo riportiamo la nostra esperienza mediante ricostruzione con lembo libero fascio-adiposo basato su doppio peduncolo vascolare (SCIA/SIEA) in una paziente affetta da microsomia emifacciale sinistra. Molteplici opzioni terapeutiche sono disponibili al fine di correggere il deficit dei tessuti molli in tale patologia: biomateriali, lipostruttura, trapianto di tessuto adiposo autologo, lembi peduncolati e lembi liberi. In letteratura sono descritti diversi lembi microchirurgici impiegati per la ricostruzione dei tessuti molli caratterizzati spesso da risultati insoddisfacenti e gravati da complicanze locoregionali. Il lembo microchirurgico fascio-adiposo basato su SCIA e SIEA presenta svariati vantaggi tra cui la doppia vascolarizzazione e la possibilità di rimodellamento differito del suddetto. A nostro giudizio dunque il lembo fascio-adiposo SCIA/SIEA rappresenta una valida opzione chirurgica nella ricostruzione dei deficit moderati e severi dei tessuti molli nei pazienti affetti da microsomia emifacciale con ridotta morbilità a livello del sito donatore e ricevente, unitamente ad un buon risultato estetico.
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