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RECONSTRUCTION OF ZYGOMATIC-FACIAL MASSIVE DEFECT USING MODIFIED BILOBED FLAP AFTER RESECTION OF SKIN CANCER

LING Bin,Keremu·Abass,HU Mei,YIN Xiaopeng,HU Lulu,LIN Zhaoquan,GONG Zhongcheng.Oncology Department of Oral & Maxillofacial Surgery,the First Hospital of Xinjiang Medical University,Stomatology College of Xinjiang Medical University,Stomatology Research Institute of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang,830054,P.R.China.  
Objective To investigate the clinical application of the modified bilobed flap in the reconstruction of zygomatic-facial massive defect after resection of skin cancer.Methods Between August 2009 and October 2011,15 patients with skin cancer in the zygomatic-facial region underwent defect reconstruction using modified bilobed flaps after surgical removal.There were 12 males and 3 females,aged 52-78 years(mean,64.1 years).The disease duration was 1-14 months(mean,4.6 months).Among the patients,there were 11 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma;1 patient had infection and the others had no skin ulceration;and tumor involved the skin layer in all patients.According to TNM staging,13 cases were rated as T2N0M2 and 2 cases as T3N0M3.The defect size ranged from 4.0 cm × 2.5 cm to 6.5 cm × 4.0 cm after cancer resection.The modified bilobed flaps consisting of pre-auricular flap and post-auricular flap was used to repair the defect after cancer resection.The size ranged from 4.0 cm × 2.5 cm to 6.5cm×4.0 cm of the first flap and from 3.0 cm × 2.0 cm to 5.0cm× 3.0 cm of the second flap.Results Partial incision dehiscence occurred in 1 case,and was cured after dressing change;the flaps survived and incision healed primarily in the other cases.Fourteen patients were followed up 12-24 months(mean,18.7 months).No recurrence was found,and the patients had no obvious face asymmetry or skin scar with normal closure of eyelid and facial nerve function.At last follow-up,the results were very satisfactory in 5 cases,satisfactory in 7 cases,generally satisfactory in 1 case,and dissatisfactory in 1 case.Conclusion The pre-and post-auricular bilobed flaps could be used to reconstruct the massive defects in the zygomatic-facial region after resection of skin cancer.
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