Onlay bone grafting simultaneous with facial soft tissue augmentation in a hemifacial microsomia patient using de-epithelialized orthograde submental flap: a technical note

Rahpeyma, Amin; Khajehahmadi, Saeedeh

doi:10.11138/ads/2014.5.1.030

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…This observation also happen in other patients with facial asymmetry. Although various surgical techniques such as dermal-fat grafting [ 30 ], local or free flap augmentation [ 31 , 32 ], and artificial materials such as silicone, hydroxyapatite and Medpor can provide facial volume augmentation [ 33 – 35 ], we prefer to use fat injection with the microautologous fat transplantation (MAFT) gun (Dermato Plastica Beauty Co., Ltd, Kaohsiung, Taiwan) because of reduced invasiveness, morbidity, and ease of repeatability [ 11 ]. Satisfactory results were obtained from this appraoch with less surgical morbidity.…”

Section: Discussionmentioning

confidence: 99%

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Yamaguchi

Lonic

et al. 2017

PLoS ONE

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BackgroundHemifacial microsomia (HFM) features hypoplasia and asymmetry in skeletal as well as soft tissue, and correction of the deformity is difficult in terms of aesthetic outcome. The purpose of this study is to examine the validity of an integrated treatment protocol for correction of this facial deformity.Patients and methodsA retrospective study was performed on adult HFM patients who received two-jaw orthognathic surgery combined with facial contouring procedures in the first stage, and fat injection for the residual facial deficiency in the second stage. Inclusion criteria were patients treated by the same surgeon and follow-up at least 6 months. The demographic, perioperative, and follow-up data were collected. We defined a facial surface area discrepancy index (FDI) for objective assessment of the symmetry between the affected and non-affected side, and utilized visual analogue scale (VAS) for subjective evaluation of facial asymmetry before and after surgical treatment.ResultsA total of 14 patients were included. The mean age at orthognathic surgery was 21.7 years. Four patients were categorized as Pruzansky-Kaban type I, while the remaining 10 patients were type II (7 patients type IIA, 3 patients type IIB). Fat injection as a secondary procedure was performed in eleven cases (79%). The mean pre- and postoperative FDI was 87.6±6.3 and 95.4±5.2 with a significant advance for symmetry (p < 0.001). The pre- and postoperative VAS for asymmetry was 7.2±1.7 and 3.8±2.4 respectively, with a significant improvement (p = 0.002).ConclusionOur integrated approach using orthognathic surgery, facial contouring surgery and subsequent fat injection is satisfactory and obtain significant improvement of the facial deformity considering the complexity of HFM.

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Section: Discussionmentioning

confidence: 99%

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Yamaguchi

Lonic

et al. 2017

PLoS ONE

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“…The de-epithelialization process entailed sharp dissection of the skin just below the hair follicles after flap elevation. Secondary epithelialization on the raw surface of subcutaneous fat exposed to the oral cavity was completed post-operatively at 3 weeks [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…De-epithelialized variant of submental flap has been previously described in literature to prevent the problem of hair-bearing skin in the oral cavity. Rahpeyma et al [ 12 ] introduced the orthograde submental flap (Pattel modification). The anterior belly of the digastric muscle and mylohyoid muscle in the pedicle half were included.…”

Section: Discussionmentioning

confidence: 99%

Modified submental platysmal adipomyofascial flap: is it a reliable alternate reconstructive option for small- to mid-sized defects especially in male patients with oral/oropharyngeal cancer?

Singh¹,

Chopra²,

Chaudhary³

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To introduce modified submental platysmal adipomyofascial flap as a new and viable hairless locoregional option for reconstruction of small-to mid-sized defects after ablative surgery in oral/oropharyngeal cancer patients keeping in mind the present pandemic situation. Methods An observational retrospective study was conducted using modified submental platysmal adipomyofascial flap as a locoregional reconstructive option for both intraoral and oropharyngeal defects in early-stage oral/oropharyngeal cancer patients, from Jan 2016 to May 2020 in a tertiary care hospital. All patients in this study were male and the overall flap outcome was evaluated with post-operative follow-up. Results Out of 18 patients, in 4 patients modified submental platysmal adipomyofascial flap was used as a combination of flaps for reconstruction. Six patients (33.33%) underwent adjuvant radiation therapy/radiation chemotherapy. The long-term functions (speech and swallowing) and cosmetic outcomes were good in the majority of the patients. One patient (5.55%) had pinhole oroantral fistula. No patient had any major flap failure. Conclusion Modified submental platysmal adipomyofascial flap can be considered as a good alternative in male patients for reconstruction of small-to mid-sized oral cavity/oropharyngeal defects post-resection, especially during the prevailing pandemic crisis. It is an oncologically safe procedure with the major advantage of providing a hairless flap for oral cavity, tonsillar and BOT resection defects with lesser donor site morbidity.

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“…If skin laxity determined in submental region by pinch test is estimated to be less than desired, then sharp dissection bellow the hair follicles should be done in the beginning of flap elevation while the overlying skin is preserved [12]. This is the sole indication for submental flap de-epihelialization in young female patients to prevent donor site morbidity.…”

Section: Discussionmentioning

confidence: 99%

A Protocol for Management of the Hairs Problem in Oral Cavity Reconstruction by Submental Flap

Rahpeyma

Khajehahmadi

2016

J. Maxillofac. Oral Surg.

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Background Submental flap is a useful aid in maxillofacial reconstruction. For intraoral usage the hairs in male patients will create some problems. Materials and Methods In a retrospective study, patients in whom submental flap had been used for reconstruction of orofacial region between 2007 and 2013, in the Mashhad University, Ghaem Hospital, were included. The ways in which the problem of hairs was solved in male patients were evaluated. Results There were 42 patients in whom submental flap was used for orofacial reconstruction. Sixty percent were males. Three ways had been used for management of intraoral hairs: radiotherapy (9 patients), second surgery (2 patients) and flap de-epithelialization (13 patients). Conclusion Deepithelialized variant of submental flap is the best option when submental flap is used for oral cavity reconstruction in male patients. Flap thickness, age, race and postoperative radiotherapy can have strong influence on this strategy.

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Onlay bone grafting simultaneous with facial soft tissue augmentation in a hemifacial microsomia patient using de-epithelialized orthograde submental flap: a technical note

Cited by 6 publications

References 20 publications

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

An integrated surgical protocol for adult patients with hemifacial microsomia: Methods and outcome

Modified submental platysmal adipomyofascial flap: is it a reliable alternate reconstructive option for small- to mid-sized defects especially in male patients with oral/oropharyngeal cancer?

A Protocol for Management of the Hairs Problem in Oral Cavity Reconstruction by Submental Flap

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