Опухоли головы и шеи. 2022; 12: 116-122
Современные возможности замещения пострезекционных дефектов орбиты и параорбитальной зоны реваскуляризированными лоскутами у пациентов со злокачественными новообразованиями: обзор литературы
Андреев Т. Р., Мудунов А. М., Доброхотова В. З.
https://doi.org/10.17650/2222-1468-2022-12-2-116-122Аннотация
Известны различные способы замещения пострезекционных дефектов орбиты и параорбитальной зоны у пациентов со злокачественными новообразованиями, но четкие критерии выбора оптимального варианта для конкретного случая пока не выработаны. В настоящем обзоре рассмотрены современные способы реконструкции таких дефектов с применением свободных реваскуляризированных лоскутов. представлена характеристика различных лоскутов, описаны их преимущества и недостатки. На основании анализа предложен алгоритм выбора оптимального способа реконструкции для конкретного пациента. Ведущим критерием в выборе метода замещения дефектов следует считать возможность обеспечения максимальных функциональных и эстетических результатов.
Список литературы
1. Disa J.J., Liew S., Cordeiro P.G. Soft-tissue reconstruction of the face using the folded/multiple skin island radial forearm free flap. Ann Plast Surg 2001;47(6):612-9. DOI: 10.1097/00000637-200112000-00006.
2. Злокачественные новообразования в России в 2020 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2021.
3. Енгибарян М.А. Метастатическое поражение органа зрения при злокачественных опухолях различных локализаций. Сибирский онкологический журнал 2009. Приложение 1. Доступно по: https://onco.tnimc.ru/upload/zhurnal/soj_2009_Pril1_66.pdf.
4. Клинические рекомендации «Злокачественные опухоли век и конъюнктивы». Общероссийская общественная организация «Ассоциация врачей-офтальмологов». 2017. Доступно по: https://oofd72.ru/upload/documents/Razrab-2-Zlokachestvennye-opuholi-vek-i-konyunktivy-_-210517_KLIN_REKOM_ZLOKACHESTVENNYE_OPUHOLI_VEK_I_KONYUNKTIVY.pdf.
5. Клинические рекомендации «Рак полости носа и придаточных пазух». Ассоциация онкологов России, Российское общество специалистов по опухолям головы и шеи, Российское общество клинической онкологии. 2018. Доступно по: https://oncology-association.ru/wp-content/uploads/2020/09/rak_polosti_nosa.pdf.
6. Brown J.S., Shaw R.J. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol 2010;11(10):1001-8. DOI: 10.1016/S1470-2045(10)70113-3.
7. Cordeiro P.G., Santamaria E. A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg 2000;105(07):2331-46, discussion 2347-2348. DOI: 10.1097/00006534-200006000-00004.
8. Cordeiro P.G., Chen C.M. A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes. Plast Reconstr Surg 2012;129(1):124-36. DOI: 10.1097/PRS.0b013e318221dca4.
9. Neligan P.C., Lipa J.E. Reconstruction of the midface. In: Procedures in Reconstructive Surgery. Ed. by G.R.D. Evans, C.E. Butle. Philadelphia: Saunders, 2009. Pp. 139-152.
10. Taylor G.I., Corlett R.J., Ashton M.W. The evolution of free vascularized bone transfer: a 40-year experience. Plast Reconstr Surg 2016;137(4):1292-1305. DOI: 10.1097/PRS.0000000000002040.
11. Watanabe K., Takahashi N., Morihisa Y. et al. Maxillary reconstruction using chimeric flaps of the subscapular artery system without vein grafts and the novel usage of chimeric flaps. J Reconstr Microsurg 2013;29(9):601-6. DOI: 10.1055/s-0033-1354736.
12. Peng X., Mao C., Yu G.Y. et al. Maxillary reconstruction with the free fibula flap. Plast Reconstr Surg 2005;115(6):1562-9. DOI: 10.1097/01.prs.0000160691.63029.74.
13. Iyer S., Thankappan K. Maxillary reconstruction: current concepts and controversies. Indian J Plast Surg 2014;47(1):8-19. DOI: 10.4103/0970-0358.129618.
14. Andrades P., Militsakh O., Hanasono M.M. et al. Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg 2011;137(8): 806-12. DOI: 10.1001/archoto.2011.132.
15. Rosenthal E., Carroll W., Dobbs M. et al. Simplifying head and neck microvascular reconstruction. Head Neck 2004;26(11): 930-6. DOI: 10.1002/hed.20076.
16. Brown J.S., Jones D.C., Summerwill A. et al. Vascularized iliac crest with internal oblique muscle for immediate reconstruction after maxillectomy. Br J Oral Maxillofac Surg 2002;40(3):183-90. DOI: 10.1054/bjom.2001.0774.
17. Sakuraba M., Kimata Y., Ota Y. et al. Simple maxillary reconstruction using free tissue transfer and prostheses. Plast Reconstr Surg 2003;111(2):594-8. DOI: 10.1097/01.PRS.0000041941.98504.B6.
18. De Boer M.F., McCormick L.K., Pruyn J.F. et al. Physical and psychosocial correlates of head and neck cancer: a review of the literature. Otolaryngol Head Neck Surg 1999;120(3):427-36. DOI: 10.1016/S0194-5998(99)70287-1.
19. Triana R.J., Uglesic V., Virag M. et al. Microvascular free flap reconstructive options in patients with partial and total maxill-ectomy defects. Arch Facial Plast Surg 2000; 2(2):91-101. DOI: 10.1001/archfaci.2.2.91.
20. Sullivan M., Gaebler C., Beukelman D. et al. Impact of palatal prosthodontic intervention on communication performance of patients' maxillectomy defects: a multilevel outcome study. Head Neck 2002; 24(6):530-8. DOI: 10.1002/hed.10095.
21. Triana R.J., Uglesic V., Virag M. et al. Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. Arch Facial Plast Surg 2000;2(2):91-101. DOI: 10.1001/archfaci.2.2.91.
22. Chepeha D.B., Moyer J.S., Bradford C.R. et al. Osseocutaneous radial forearm free tissue transfer for repair of complex midfacial defects. Arch Otolaryngol Head Neck Surg 2005;131(6):513-7. DOI: 10.1001/archotol.131.6.513.
23. Cordeiro P.G., Bacilious N., Schantz S., Spiro R. The radial forearm osteocutaneous “sandwich” free flap for reconstruction of the bilateral subtotal maxillectomy defect. Ann Plast Surg 1998;40(4):397-402. DOI: 10.1097/00000637-199804000-00013.
24. Andrades P., Rosenthal E.L., Carroll W.R. et al. Zygomatic-maxillary buttress reconstruction of midface defects with the osteocutaneous radial forearm free flap. Head Neck 2008;30(10):1295-302. DOI: 10.1002/hed.20874.
25. Virgin F.W., Iseli T.A., Iseli C.E. et al. Functional outcomes of fibula and osteocutaneous forearm free flap reconstruction for segmental mandibular defects. Laryngoscope 2010;120(4):663-7. DOI: 10.1002/lary.20791.
26. Futran N.D., Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol 2006;7(3):249-58. DOI: 10.1016/S1470-2045(06)70616-7.
27. Futran N.D., Wadsworth J.T., Villaret D., Farwell D.G. Midface reconstruction with the fibula free flap. Arch Otolaryngol Head Neck Surg 2002;128(2):161-6. DOI: 10.1001/archotol.128.2.16
28. Genden E.M., Wallace D., Buchbinder D. et al. Iliac crest internal oblique osteomusculocutaneous free flap reconstruction of the postablative palatomaxillary defect. Arch Otolaryngol Head Neck Surg 2001;127(7):854-61.
29. Bidros R.S., Metzinger S.E., Guerra A.B. The thoracodorsal artery perforatorscapular osteocutaneous (TDAP-SOC) flap for reconstruction of palatal and maxillary defects. Ann Plast Surg 2005;54(1):59-65. DOI: 10.1097/01.sap.0000139561.64564.d7.
Head and Neck Tumors (HNT). 2022; 12: 116-122
Current capabilities of replacement of postresection defects of the orbit and periorbital zone with revascularized grafts in patients with malignant tumors: literature review
Andreev T. R., Mudunov A. M., Dobrokhotova V. Z.
https://doi.org/10.17650/2222-1468-2022-12-2-116-122Abstract
Various techniques for replacement of postresection defects of the orbit and periorbital zone in patients with malignant tumors are known, but clearly defined criteria for selection of the optimal variant have not been developed. This review considers current techniques of reconstruction of these defects using free revascularized grafts. Characteristics of various grafts, their advantages and disadvantages are described. Based on the analysis, algorithm of selection of the optimal methods of reconstruction for individual patients is proposed. The main criterion in selection of defect replacement techniques is the possibility of achieving the maximal functional and esthetic results.
References
1. Disa J.J., Liew S., Cordeiro P.G. Soft-tissue reconstruction of the face using the folded/multiple skin island radial forearm free flap. Ann Plast Surg 2001;47(6):612-9. DOI: 10.1097/00000637-200112000-00006.
2. Zlokachestvennye novoobrazovaniya v Rossii v 2020 godu (zabolevaemost' i smertnost'). Pod red. A.D. Kaprina, V.V. Starinskogo, A.O. Shakhzadovoi. M.: MNIOI im. P.A. Gertsena - filial FGBU «NMITs radiologii» Minzdrava Rossii, 2021.
3. Engibaryan M.A. Metastaticheskoe porazhenie organa zreniya pri zlokachestvennykh opukholyakh razlichnykh lokalizatsii. Sibirskii onkologicheskii zhurnal 2009. Prilozhenie 1. Dostupno po: https://onco.tnimc.ru/upload/zhurnal/soj_2009_Pril1_66.pdf.
4. Klinicheskie rekomendatsii «Zlokachestvennye opukholi vek i kon\"yunktivy». Obshcherossiiskaya obshchestvennaya organizatsiya «Assotsiatsiya vrachei-oftal'mologov». 2017. Dostupno po: https://oofd72.ru/upload/documents/Razrab-2-Zlokachestvennye-opuholi-vek-i-konyunktivy-_-210517_KLIN_REKOM_ZLOKACHESTVENNYE_OPUHOLI_VEK_I_KONYUNKTIVY.pdf.
5. Klinicheskie rekomendatsii «Rak polosti nosa i pridatochnykh pazukh». Assotsiatsiya onkologov Rossii, Rossiiskoe obshchestvo spetsialistov po opukholyam golovy i shei, Rossiiskoe obshchestvo klinicheskoi onkologii. 2018. Dostupno po: https://oncology-association.ru/wp-content/uploads/2020/09/rak_polosti_nosa.pdf.
6. Brown J.S., Shaw R.J. Reconstruction of the maxilla and midface: introducing a new classification. Lancet Oncol 2010;11(10):1001-8. DOI: 10.1016/S1470-2045(10)70113-3.
7. Cordeiro P.G., Santamaria E. A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg 2000;105(07):2331-46, discussion 2347-2348. DOI: 10.1097/00006534-200006000-00004.
8. Cordeiro P.G., Chen C.M. A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I. Algorithm and outcomes. Plast Reconstr Surg 2012;129(1):124-36. DOI: 10.1097/PRS.0b013e318221dca4.
9. Neligan P.C., Lipa J.E. Reconstruction of the midface. In: Procedures in Reconstructive Surgery. Ed. by G.R.D. Evans, C.E. Butle. Philadelphia: Saunders, 2009. Pp. 139-152.
10. Taylor G.I., Corlett R.J., Ashton M.W. The evolution of free vascularized bone transfer: a 40-year experience. Plast Reconstr Surg 2016;137(4):1292-1305. DOI: 10.1097/PRS.0000000000002040.
11. Watanabe K., Takahashi N., Morihisa Y. et al. Maxillary reconstruction using chimeric flaps of the subscapular artery system without vein grafts and the novel usage of chimeric flaps. J Reconstr Microsurg 2013;29(9):601-6. DOI: 10.1055/s-0033-1354736.
12. Peng X., Mao C., Yu G.Y. et al. Maxillary reconstruction with the free fibula flap. Plast Reconstr Surg 2005;115(6):1562-9. DOI: 10.1097/01.prs.0000160691.63029.74.
13. Iyer S., Thankappan K. Maxillary reconstruction: current concepts and controversies. Indian J Plast Surg 2014;47(1):8-19. DOI: 10.4103/0970-0358.129618.
14. Andrades P., Militsakh O., Hanasono M.M. et al. Current strategies in reconstruction of maxillectomy defects. Arch Otolaryngol Head Neck Surg 2011;137(8): 806-12. DOI: 10.1001/archoto.2011.132.
15. Rosenthal E., Carroll W., Dobbs M. et al. Simplifying head and neck microvascular reconstruction. Head Neck 2004;26(11): 930-6. DOI: 10.1002/hed.20076.
16. Brown J.S., Jones D.C., Summerwill A. et al. Vascularized iliac crest with internal oblique muscle for immediate reconstruction after maxillectomy. Br J Oral Maxillofac Surg 2002;40(3):183-90. DOI: 10.1054/bjom.2001.0774.
17. Sakuraba M., Kimata Y., Ota Y. et al. Simple maxillary reconstruction using free tissue transfer and prostheses. Plast Reconstr Surg 2003;111(2):594-8. DOI: 10.1097/01.PRS.0000041941.98504.B6.
18. De Boer M.F., McCormick L.K., Pruyn J.F. et al. Physical and psychosocial correlates of head and neck cancer: a review of the literature. Otolaryngol Head Neck Surg 1999;120(3):427-36. DOI: 10.1016/S0194-5998(99)70287-1.
19. Triana R.J., Uglesic V., Virag M. et al. Microvascular free flap reconstructive options in patients with partial and total maxill-ectomy defects. Arch Facial Plast Surg 2000; 2(2):91-101. DOI: 10.1001/archfaci.2.2.91.
20. Sullivan M., Gaebler C., Beukelman D. et al. Impact of palatal prosthodontic intervention on communication performance of patients' maxillectomy defects: a multilevel outcome study. Head Neck 2002; 24(6):530-8. DOI: 10.1002/hed.10095.
21. Triana R.J., Uglesic V., Virag M. et al. Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. Arch Facial Plast Surg 2000;2(2):91-101. DOI: 10.1001/archfaci.2.2.91.
22. Chepeha D.B., Moyer J.S., Bradford C.R. et al. Osseocutaneous radial forearm free tissue transfer for repair of complex midfacial defects. Arch Otolaryngol Head Neck Surg 2005;131(6):513-7. DOI: 10.1001/archotol.131.6.513.
23. Cordeiro P.G., Bacilious N., Schantz S., Spiro R. The radial forearm osteocutaneous “sandwich” free flap for reconstruction of the bilateral subtotal maxillectomy defect. Ann Plast Surg 1998;40(4):397-402. DOI: 10.1097/00000637-199804000-00013.
24. Andrades P., Rosenthal E.L., Carroll W.R. et al. Zygomatic-maxillary buttress reconstruction of midface defects with the osteocutaneous radial forearm free flap. Head Neck 2008;30(10):1295-302. DOI: 10.1002/hed.20874.
25. Virgin F.W., Iseli T.A., Iseli C.E. et al. Functional outcomes of fibula and osteocutaneous forearm free flap reconstruction for segmental mandibular defects. Laryngoscope 2010;120(4):663-7. DOI: 10.1002/lary.20791.
26. Futran N.D., Mendez E. Developments in reconstruction of midface and maxilla. Lancet Oncol 2006;7(3):249-58. DOI: 10.1016/S1470-2045(06)70616-7.
27. Futran N.D., Wadsworth J.T., Villaret D., Farwell D.G. Midface reconstruction with the fibula free flap. Arch Otolaryngol Head Neck Surg 2002;128(2):161-6. DOI: 10.1001/archotol.128.2.16
28. Genden E.M., Wallace D., Buchbinder D. et al. Iliac crest internal oblique osteomusculocutaneous free flap reconstruction of the postablative palatomaxillary defect. Arch Otolaryngol Head Neck Surg 2001;127(7):854-61.
29. Bidros R.S., Metzinger S.E., Guerra A.B. The thoracodorsal artery perforatorscapular osteocutaneous (TDAP-SOC) flap for reconstruction of palatal and maxillary defects. Ann Plast Surg 2005;54(1):59-65. DOI: 10.1097/01.sap.0000139561.64564.d7.
События
-
Журнал «Хирургическая практика» теперь на Elpub >>>
27 янв 2026 | 14:31 -
К платформе Elpub присоединился журнал «Journal of Advanced Materials and Technologies» >>>
26 янв 2026 | 14:29 -
К платформе Elpub присоединился журнал «Постколониализм и современность» >>>
22 янв 2026 | 14:25 -
К платформе Elpub присоединился журнал «Фармакоинформатика и фармаконутрициология. Современный анализ данных» >>>
15 янв 2026 | 14:23 -
Интеграция Elpub c ИС "Метафора" >>>
15 янв 2026 | 14:10
