Surgical Management of Progressive Hemifacial Atrophy With De-Epithelialized Profunda Artery Perforator Flap: A Case Report

Lőcsei, Zoltán; Janovszky, Ágnes; Lázár, Péter; Piffkò, József

doi:10.1016/j.joms.2016.10.020

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…The disorder is usually slowly progressive. The defect becomes more pronounced in long duration, leading to esthetic and functional deficits ( 51 ). Patients may experience halting of the facial atrophy.…”

Section: Resultsmentioning

confidence: 99%

Progressive Hemifacial Atrophy and Linear Scleroderma En Coup de Sabre: A Spectrum of the Same Disease?

Хамаганова

2018

Front. Med.

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Similar clinical and histhopathological features in progressive hemifacial atrophy and linear scleroderma en coup de sabre are well known. Trauma may predispose to the development of both diseases. The lack of association with anti-Borrelia antibodies was shown in both cases as well. The otolaryngological and endocrine disorders may be associated findings in both diseases. However, there are certain differences in neurological and ophthalmological changes in the diseases.

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Section: Resultsmentioning

confidence: 99%

Progressive Hemifacial Atrophy and Linear Scleroderma En Coup de Sabre: A Spectrum of the Same Disease?

Хамаганова

2018

Front. Med.

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“…Furthermore, adipofascial flaps have minimal donor-site morbidity and can provide a stable anatomical repair for severe PHA in the long term. 23 The circumflex scapular artery-based adipofascial flap is the fascial component of the wellknown scapular or parascapular flaps and was first reported in 1987. 24 Circumflex scapular arterybased adipofascial flaps are a feasible option for PHA patients, as these flaps cause minimal donorsite morbidity and result in thin, durable coverage of the wounds .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, adipofascial flaps have minimal donor-site morbidity and can provide a stable anatomical repair for severe PHA in the long term. 23…”

Section: Discussionmentioning

confidence: 99%

Treatment of Progressive Hemifacial Atrophy by Cartilage Graft and Free Adipofascial Flap Combined with 3D Planning and Printing

He¹,

Liu²,

Khatter³

et al. 2023

Plastic &Amp; Reconstructive Surgery

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rogressive hemifacial atrophy (PHA) is also named Parry-Romberg syndrome, which was first reported by Parry in 1825 and established as a syndrome by Romberg in 1846. 1 It is an infrequent disease characterized by progressive atrophy of skin, soft tissue, muscles, and underlying bone structures in a hemifacial distribution. 2 This rare disorder usually begins in the first decade of life, and slowly progresses for 2 to 20 years before stabilizing. 3 The pathogenesis of PHA is not well understood. Trauma, infection, immune abnormality, cranial vascular malformation, and sympathetic dysfunction have all been implicated in this disease. 4 Although immunosuppressive treatment may slow down the progression of the disease, affected patients with obvious facial Background: Progressive hemifacial atrophy (PHA) is a rare disease characterized by progressive atrophy of skin, soft tissue, muscles, and underlying bone structures. For severe PHA patients with obvious bone deformities, skeletal framework reconstruction is needed in addition to soft-tissue augmentation. The authors propose a new combinatorial surgical method using rib cartilage graft and free adipofascial flap for restoring facial symmetry. To improve the surgical accuracy, preoperative three-dimensional planning and printing was used. Methods: Twelve patients with severe facial atrophy were included in the authors' study. Three-dimensional facial image analyses were performed preoperatively to quantify the facial asymmetry. Rib cartilages were harvested and sculptured to the appropriate shape created by three-dimensional planning and fixed to the atrophic bone. The circumflex scapular artery-based adipofascial flap was transplanted to repair soft-tissue deficiency. A residual small monitor flap was left with the adipofascial flap. A revision surgery was performed to perfect the repair if the contour was suboptimal 6 months postoperatively. Results: The adipofascial flaps survived in all 12 patients. All patients achieved good healing without complications. At 1 more year after surgery, the rib cartilage was still in position and rarely absorbed. The morphologic and volumetric difference between the affected side and the unaffected side was improved significantly postoperatively. All patients were satisfied with the results, and no more additional operations were required. Conclusion:The combinatorial surgery of rib cartilage graft and free adipofascial flap in the setting of three-dimensional planning and printing can be a good choice in restoring facial symmetry in severe cases of PHA.

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“…Similarly, such fair to excellent swallowing and speech recovery was reported by Ferna ´ndez-Riera et al using PAPF reconstruction after hemiglossectomy 29 (Table 5). [35][36][37] In our daily practice, the choices of PAPFs or ALTPFs are mainly based on 4 elements: body mass index and defect, CTA result, number of skin paddles, and patient preference. First, for the patient with a middle-sized defect and body mass index .35 kg/m 2 (extremely obese), we tend to use ALTPFs for reconstructions.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, such fair to excellent swallowing and speech recovery was reported by Fernández‐Riera et al using PAPF reconstruction after hemiglossectomy 29 (Table 5). 35–37 …”

Section: Discussionmentioning

confidence: 99%

Profunda Artery Perforator Flaps From the Posteromedial Region of the Thigh for Head and Neck Reconstruction

Gao

Zhu

et al. 2022

Otolaryngol.--head neck surg.

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Objective Profunda femoris artery perforator flaps (PAPFs) have not been widely used in head and neck reconstructions. The feasibility and outcomes of PAPFs for various head and neck reconstructions need to be investigated. Study Design Retrospective analysis. Setting A single-institution review. Methods PAPFs were utilized in head and neck reconstructions from 2019 to 2021. Local anatomy, surgical technique, and complications were discussed. Chimeric PAPF applications with muscle components were described for coverage of extensive multiunit defects. Additionally, aesthetic and functional outcomes were compared with anterolateral thigh perforator flaps. Results A total of 33 cases were included. The average age was 54.2 years (range, 30-74). The most common underlying pathology was oral squamous cell carcinoma (n = 26, 78.8%), while the mean ± SD body mass index was 25.4 ± 2.8 kg/m2. Middle perforators (n = 14, 42.4%) were the most commonly utilized ones. The perforator-based chimeric/composite applications were used in 9 (27.3%), with the muscular components consisting of gracilis (n = 3, 9.1%), adductor magnus (n = 5, 15.2%), or semimembranosus muscles (n = 1, 3.0%). Venous thromboses of the PAPFs were found in 2 (6.1%), though salvaged. The occurrence of postoperative 90-day morbidity (complication) was related to mandibulectomy/maxillectomy ( P = .020). Postoperative validated questionnaires showed a trend of intermediate to high scores, indicating noninferior outcomes in several categories, when compared with the anterolateral thigh perforator flap counterparts. Conclusion PAPFs are a good reconstructive alternative for intermediate to large head and neck reconstructions. Besides, PAPFs can provide sufficient tissue volume and versatility of potentially incorporating adjacent muscle components.

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Surgical Management of Progressive Hemifacial Atrophy With De-Epithelialized Profunda Artery Perforator Flap: A Case Report

Cited by 5 publications

References 33 publications

Progressive Hemifacial Atrophy and Linear Scleroderma En Coup de Sabre: A Spectrum of the Same Disease?

Progressive Hemifacial Atrophy and Linear Scleroderma En Coup de Sabre: A Spectrum of the Same Disease?

Treatment of Progressive Hemifacial Atrophy by Cartilage Graft and Free Adipofascial Flap Combined with 3D Planning and Printing

Profunda Artery Perforator Flaps From the Posteromedial Region of the Thigh for Head and Neck Reconstruction

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