안면부 동정맥 기형의 수술적 제거 후 흉배동맥 천공지유리피판을 이용한 결손의 재건 = Reconstruction of the Face Using Thoracodorsal Artery Perforator Free Flap after Resection of Arteriovenous Malformation

다국어 초록 (Multilingual Abstract)

Purpose: The treatment of arteriovenous malformation
(AVM) of the face remains a difficult challenge in plastic
surgery. Incomplete resection resulting in uncontrolled
bleeding, postoperative enlargement of the remaining
malformation, and a poor functional and cosmetic result
could be the problems confronted by the surgeons.
Methods: A 37 year-old male with large arteriovenous
malformation in face treated with preoperative superselective
transarterial embolization and free flap transfer. The size
of the defect was 13 × 9 cm. Sclerotheraphy without resection
were performed several times but the results were
unsatisfactory. Resection was performed the next day of
embolization. We were able to repair with the thoracodorsal
artery perforator free flap. And facial muscle reconstruction
performed by simultaneous muscle and nerve transfer.
Results: During the follow-up period 8 months the
patient regained an acceptable cosmetic appearance. And
he has shown no reexpansion of the malformation.
Conclusion: The thoracodorsal artery perforator free
flap could be a good choice for the reconstruction for massive
defects of the face. A huge arteriovenous malformation
could be safely removed and successfully reconstructed
by the complete embolization, wide excision and
coverage with a well vascularized tissue.

참고문헌 (Reference)

1 김성덕, "선천성 동정맥기형의 선택적 색전술 후 수술적 제거" 대한성형외과학회 30 (30): 12-760, 2003

2 Schwabegger AH, "Thoracodorsal artery perforator (TAP) flap: report of our experience and review of the literature" 55 : 390-, 2002

3 Hong JP, "Reconstruction of the face after resection of arteriovenous malformation using anterolateral thigh perforator flap" 16 (16): 51-, 2005

4 Tark KC, "Histologic change of arteriovenous malformations of the face and scalp after free flap transfer" 106 : 87-, 2000

5 Hurwitz DJ, "Hemodynamic considerations in the treatment of arteriovenous malformations of the face and scalp" 67 : 421-, 1981

6 Koshima I, "Free perforator flap for the treatment of defects after resection of huge arteriovenous malformations in the head and neck regions" 51 : 194-, 2003

7 Tark KC, "Free flap transfer for treatment of facial arteriovenous malformations" 17 : 232-, 1990

8 Weinzweig N, "Arteriovenous malformation of the forehead, anterior scalp, and nasal dorsum" 5 : 2433-, 2000