Facial nerve reconstruction using a vascularized lateral femoral cutaneous nerve graft based on the superficial circumflex iliac artery system: an application of the inferolateral extension of the groin flap.
The use of an inferolateral extension technique of a groin flap has previously been reported. This technique involves harvesting an extended portion from the anterolateral thigh, including the lateral femoral cutaneous nerve (LFCN) and its accompanying vessels, attached to a groin flap via communications between the LFCN-accompanying vessels and the superficial circumflex iliac artery (SCIA) system. In this study, we used this technique involving a vascularized LFCN combined with a groin flap to reconstruct a facial nerve defect. The patient was a 58-year-old man with a salivary duct carcinoma in the left parotid gland. Tumor ablation resulted in a defect of the skin and soft tissue including all branches of the facial nerve. A free groin flap was harvested based on the SCIA system, composed of the LFCN and a small monitoring flap, which were nourished by the LFCN-accompanying vessels and by communication with the SCIA system. The LFCN was transplanted into the gaps in the facial nerve branches as a cable graft, and the skin flap was used to cover and fill the soft tissue defect. The postoperative course was uneventful and satisfactory facial animation was obtained. This represents a possible technique for nerve reconstruction using a vascularized nerve graft.
Kashiwa
Katsuhiko
K
Department of Plastic, Reconstructive and Aesthetic Surgery, Iwate Medical University, Faculty of Medicine, Uchimaru, Morioka, Japan. kkashiwa@iwate-med.ac.jp
Kobayashi
Seiichiro
S
Nasu
Wakako
W
Kuroda
Takashi
T
Higuchi
Hirofumi
H
D044584:Carcinoma, Ductal / Q000473:pathology / Q000601:surgery; D004954:Esthetics; D005154:Facial Nerve / Q000601:surgery*; D005267:Femoral Nerve / Q000601:surgery / Q000637:transplantation; D006085:Graft Survival; D006801:Humans; D007083:Iliac Artery / Q000601:surgery / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D013848:Thigh / Q000098:blood supply* / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology