Connie C. Ma MD, Clara Si BA, Feyisayo Adegboye BA, Jaclyn Lee MD, Ina Lee BS, MS, Scott J. Stephan MD, Priyesh N. Patel MD, Shiayin F. Yang MD
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引用次数: 0
Abstract
Objective
To determine whether and when early division of the paramedian forehead flap may be safely performed.
Data Sources
PubMed (NLM), Scopus (Elsevier), and Embase (Elsevier).
Methods
A systematic search of PubMed, Scopus, and Embase was conducted according to PRISMA guidelines. Data extraction included time to pedicle division, patient and defect characteristics, and postoperative complications. Additionally, a retrospective analysis of patients at our institution was performed to augment the cohort.
Results
A total of 103 patients (85 from 6 studies identified via systematic review and 18 via retrospective review) underwent early flap division defined as 16 days and earlier. The average time to division was 9.89 days (3–16). There were no cases of flap loss, and complications were rare. Several studies excluded full thickness defects. Five studies included patients requiring cartilage grafting, although some limited this to less than 50% of the defect area. All patients in our retrospective cohort had partial thickness defects and none required cartilage grafting. Despite smoking being a major risk factor for vascular disease, 13.7% of patients were current smokers. Several studies utilized imaging tools such as indocyanine green angiography to assess flap perfusion. Notably, in these instances, no cases were delayed due to lack of adequate neovascularization.
Conclusion
Early paramedian forehead flap division may be an option in select patients with partial thickness nasal defects. Adjunct imaging may be a cost-effective method of evaluating appropriate timing of division.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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