Preoperative planning for advanced modelling of anterolateral thigh flaps in the treatment of severe haemifacial atrophy in Parry–Romberg and Goldenhar.

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Presentation transcript:

Preoperative planning for advanced modelling of anterolateral thigh flaps in the treatment of severe haemifacial atrophy in Parry–Romberg and Goldenhar syndrome Kamil Firudinovich Abdullaev, Ekaterina Valerievna Orlova, Manish Kumar Yadav, Evgeny Alexandrovich Vasilyev, Mikhail Arkad’evich Mokhirev, Kseniya Sergeevna Gileva JPRAS Open Volume 16, Pages 36-49 (June 2018) DOI: 10.1016/j.jpra.2018.02.001 Copyright © 2018 The Author(s) Terms and Conditions

Figure 1 First patient, preoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 2 First patient, postoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 3 First patient, post revision surgery at 8-month follow-up, frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 4 Second patient, preoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 5 Second patient, intraoperative left lateral view of the face. Extended preauricular incision with an individually modelled de-epithelised adipocutaneous ALT flap with skin paddle placed over the affected region. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 6 Second patient, postoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 7 Third patient, preoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 8 Third patient, intraoperative template in situ on right thigh. Data noted on the template to guide the appropriate thickness of the ALT flap in different areas, as obtained from digital analysis (see Table 3). JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 9 Third patient, intraoperative varying thickness of ALT flap harvest. Harvest of a primary-thinned adipocutaneous ALT flap in progress. Ruler and forceps demonstrating the varying thickness in different areas of the ALT flap as per the template (see Figure 8). JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 10 Third patient, intraoperative right lateral view of the face with flap in situ. The primary-thinned and modelled ALT flap placed over the recipient site after revascularisation (prior to de-epithelialisation). The varying thickness of the ALT flap is evident, as it matches the natural contour of the affected region. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Figure 11 Third patient, postoperative frontal view. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Screen dump 1 NHP Bone and Skin images. JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions

Screen dump 2 Superimposed 3-D Photos and CAT Images in Nemotech Studio (green – affected side measurements; pink – healthy side measurements). JPRAS Open 2018 16, 36-49DOI: (10.1016/j.jpra.2018.02.001) Copyright © 2018 The Author(s) Terms and Conditions