Augmentation of facial soft tissue is frequently encountered in various diseases, one of which is Romberg´s disease, progressive hemifacial atrophy.
By serratus anterior free flap, the authors successfully augmented the depressed lesion of the face in 2 cases of Romberg´s disease. This muscle free flap has several advantages in reconstruction of facial deformity. First, this muscle has enough volume to augment the atrophic lesion of the face. Second, the form of slips of serratus anterior muscle and the posterior entry of the vascular pedicle allow separation of the slips anteriorly, and therefore, serratus anterior free flap is useful to fill the irregular defect selectively. Third, this muscle can be transfered in combination with other muscles, skin, and bones, and has versatility to provide various components of tissues. Fourth, as muscle flap has adequate structureal strength, it will not sag as omentum free flap does, and will not distort the facial expression. Furthermore, in the cases with facial palsy, functional reconstruction is possible by reinnervation. Finally, this muscle flap has an abundant blood flow, an the implantation of this free flap provides a new plentiful source of blood into the atrophic lesion, which may be expected to have a beneficial influence on the disease coures.
|