Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
Chapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2lap its a good option to reconstruct various defects in the head and neck*. Since this description, the submental island has struggled to gain a strong foolhold as a reliable flap in the reconstruction of head and neck defects. Two likely reasons for tile slow and reluctant acceptance of this flap i Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2nto the everyday use by head neck reconstructive surgeons has been the difficult dissection of the flap along tile submandibular gland area as well asEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
concern for its use in patients with oral cavity cancers. Tile Litter is due to the belief or fear of potentially transferring nodal disease to the rChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2e submental island flap is a fantastic option for the reconstruction of defects in the head and neck extending from die oral cavity, oropharynx, hypopharynx, maxilla, as well as various sites in the face such as the parotid bed, chin, face, upper and lower lip, and in neck defects.I he main disadvan Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2tage of the submental island flap is the dissection of the pedicle near the takeoff of the facial artery and vein as the vessels travel through the suEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
bmandibular gland. Dissection in this area can be very tedious and a potential site for problems, particularly of the veins leading to venous congestiChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2roviding the ability to primarily close the donor site. The location of the donor site scar is well hidden, particularly when the patient is standing upright.AnatomyThe submental artery island flap is a type c fasciocuta-neous flap with its dominant pedicle based on the submental artery, which arise Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2s approximately 5-6.5 cm from the origin of the facial artery.* Hie facial artery has a mean diameter of 2.7 nun at its origin form the external carotEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
id artery. I he submental artery emerges from the medial portion of the facial artery 5-7 mm inferior to the mandibular border, 3 5 cm anterior to theChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2y across the mylohyoid muscle. As it continues its course, the artery gives branches to the submandibular gland, the platysma, digastric and mylohyoid muscles, small branches to the subpkitysmal fatty layer, and 1 4 cutaneous perforators.’ lhese perforators pierce the platysma and terminate in the s Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2ubdermal plexus connected with the contralateral artery, allowing for skin perfusion of both tile ipsiLiteral and contralateral neck.4 Ulis enables aEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
flap to be raised from the mandibular left angle to the right angle with a width of 7-8 cm and a length of 15-18 cm, a territory of 45 X 10-2 cm2.5 ThChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2ng flap harvest the ipsilateral anterior belly of the digastric is included, as the artery has been found to lie deep to the muscle in 70% of cases. The pedicle length ranges from 5 to 8 cm giving a significant arc of rotation extending from the medial canthus to the zygomatic arrh. The venous drain Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2age is via the submental vein, which has a mean diameter of 2.2 mm. It drains into the facial vein, which has a mean diameter of 2.5 mm. Tile caliberEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
of the submental vessels, make this flap suitable for microvascular transfer. The sensory nerve supply to this region is viaLocal and Regional Flaps iChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2nc.Companion website: www.wiley.com/go/iemandcs/flapsreconstructkxi103104 Local and regional flaps in head & neck reconstructionflu- transverse cervical nerves. Motor innervation is via the cervical branch of the facial nerve. On dissection care must be taken to avoid injury to the marginal mandibul Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2ar branch of the facial nerve as it can travel a mean of 12 mm away from the submental artery.Flap harvest•The first step in the harvest of the submenEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
tal artery flap is the determination of the amount of skin that can be harvested while allowing for primary closure of Hie defect. This can be done wiChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2 allowing for advancement of the remaining neck skin to close to the skin at the inferior bonier of the mandible.•Once the skin amount is determined, an elliptical skin island is marked out as needed. The amount of skin can extend laterally to the posterior border of the mandible or the mastoid area Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2.•If the (lap is being raised in conjunction with a neck dissection, the ipsilateral posterior border of the skin island is extended to meet the neckEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
dissection in an apron-type incision.•A Doppler scan may lie used to help determine the trajectory of the pedicle, but this is not necessary.•Flap raiChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2from the skin, the subcutaneous tissue, and to the fascia of die contralateral anterior belly of the digastric. Skin incision is also extended inferiorly towards the ipsilateral aspect of the pedicle.•Dissection is extended to the midline over Hie mylohyoid muscle and tile ipsilateral .interior diga Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2stric muscle.•Ihe attachment of the anterior digastric muscle is detached from the mandible and it is sectioned inferiorly at the intermediate tendon.Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
•At this point, dissection is carefully carried out towards the facial artery hugging the inferior border of the mandible where the submental vascularChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2ilitate the inspection and dissection of the pedicle. This portion of the dissection can also be carried out at the beginning of the flap harvest with a circumferential incision and elevation of the subplatysinal flap.•Taking care to identify the facial vessels and the marginal mandibular branch of Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2the facial nerve, the fascia is elevated superiorly to protect the nerve.•Dissection in this region approaches the submandibular gland. At this point,Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
dissection should be carried out with a bipolar electrocautery to minimize damage to the vascular pedicle.•Luger vascular branches of the vascular peChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2int, the submental artery and vein are completely dissected to the takeoff at the facial vessels.Transfer to the oral cavity•Once the flap pedicle is completely dissected, the flap is ready to be* transferred to the oral cavity if that is where the defect is located.•Prior to the transfer of the ped Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2icle, a tunnel from the neck to the oral cavity must lie created.•rhe usual transfer to the oral cavity isdone by forming a tuiuiel along the mylohyoiEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
d muscle. This dissection can be done from tile neck and the tunnel connected to the oral cavity via the resection defect.•Care should lie taken to inChapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new fl Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2 outflow or perfusion.•Once the tunnel is made, a large Kelly clamp is passed from the oral cavity to the neck. I he skin edge of the flap is secured w ith the Kelly clamp and the flap is gently teased into the oral cavity. Once in tile oral cavity, the contour and alignment is oriented for the most Ebook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2 effective position and the pedicle in the neck is checked to insure that it is not twisted.•The flap is then inset and the neck closed over a vacuumEbook Local and regional flaps in head amp; neck reconstruction - A practical approach: Part 2
drain.Chapter 14Submental island flapIntroductionThe submental island flap was first mentioned in the literature by Martin rt al., who described this new flGọi ngay
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