A New Facial Composite Flap Model (Panorama Facial Flap) with Sensory and Motor Nerve from Cadaver Study for Facial Transplantation

얼굴이식을 위한 운동과 감각신경을 가진 중하안면피판 모델(파노라마 얼굴피판)에 대한 연구

  • Kim, Peter Chan Woo (Department of Plastic and Reconstructive Surgery, Daegu Catholic University Medical Center) ;
  • Do, Eon Rok (Department of Plastic and Reconstructive Surgery, Daegu Catholic University Medical Center) ;
  • Kim, Hong Tae (Department of Anatomy, School of Medicine, Daegu Catholic University)
  • 김찬우 (대구가톨릭대학교 의료원 성형외과학교실) ;
  • 도언록 (대구가톨릭대학교 의료원 성형외과학교실) ;
  • 김홍태 (대구가톨릭대학교 의과대학 해부학교실)
  • Received : 2011.02.15
  • Accepted : 2011.09.14
  • Published : 2011.11.10

Abstract

Purpose: The purpose of this study was to investigate the possibility that a dynamic facial composite flap with sensory and motor nerves could be made available from donor facial composite tissue. Methods: The faces of 3 human cadavers were dissected. The authors studied the donor faces to assess which facial composite model would be most practicable. A "panorama facial flap" was excised from each facial skeleton with circumferential incision of the oral mucosa, lower conjunctiva and endonasal mucosa. In addition, the authors measured the available length of the arterial and venous pedicles, and the sensory nerves. In the recipient, the authors evaluated the time required to anastomose the vessels and nerve coaptations, anchor stitches for donor flaps, and skin stitches for closure. Results: In the panorama facial flap, the available anastomosing vessels were the facial artery and vein. The sensory nerves that required anastomoses were the infraorbital nerve and inferior alveolar nerve. The motor nerve requiring anstomoses was the facial nerve. The vascular pedicle of the panorama facial flap is the facial artery and vein. The longest length was 78 mm and 48 mm respectively. Sensation of the donor facial composite is supplied by the infraorbital nerve and inferior alveolar nerve. Motion of the facial composite is supplied by the facial nerve. Some branches of the facial nerve can be anastomosed, if necessary. Conclusion: The most practical facial composite flap would be a mid and lower face flap, and we proposed a panorama facial flap that is designed to incorporate the mid and lower facial skin with and the unique tissue of the lip. The panorama facial composite flap could be considered as one of the practicable basic models for facial allotransplantation.

Keywords

References

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