Flashcards on Progressive Hemifacial Atrophy: Romberg's Syndrome
Progressive Hemifacial Atrophy: Romberg's Syndrome Guide
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Facial reconstruction
31 cards
Card 1
Question: What are the main advantages of surgical reconstruction for facial soft-tissue deficits?
Answer: Surgical reconstruction offers the largest amount of tissue with excellent safety and is often combined with fillers for best outcomes.
Card 2
Question: Why are local pedicled flaps limited for extensive facial soft-tissue defects?
Answer: They lack adequate bulk for extensive deficits despite options like superficial temporal pedicle-based flaps.
Card 3
Question: What modification has been described to increase bulk of a superficial temporal flap?
Answer: Augmenting the flap with a free dermis–fat graft sandwiched between folded superficial temporal fascia.
Card 4
Question: Which small free flaps can be used for smaller facial deficits?
Answer: Smaller muscle or fascial flaps such as the gracilis and the radial forearm adipofascial flap.
Card 5
Question: Which free flap provides substantial soft-tissue bulk for larger facial contour reconstruction?
Answer: The deep inferior epigastric perforator (DIEP) flap can provide more soft-tissue bulk.
Card 6
Question: What flap is useful in heavier patients as a source of fat for soft-tissue volume, and what are its supply vessels?
Answer: The omentum provides fat and is supplied by either the right or left gastroepiploic arteries; harvest requires abdominal entry.
Card 7
Question: What is a notable long-term drawback of using the omentum for facial soft-tissue reconstruction?
Answer: The omentum lacks internal structure and often leads to soft-tissue descent over time.
Card 8
Question: Name other flap options mentioned for facial reconstruction besides DIEP and omentum.
Answer: Superficial inferior epigastric flap, transverse rectus abdominis muscle (TRAM) flap, and deltopectoral flap.
Card 9
Question: What are the advantages of the anterolateral thigh (ALT) adipofascial flap?
Answer: Can be harvested with patient supine away from inset area, provides a large reliable skin flap, proximity to muscles that can be included for bulk, an
Card 10
Question: What are the disadvantages of the ALT adipofascial flap?
Answer: Variability of skin perforators and potentially tedious pedicle dissection if it courses within muscle for a long distance.