Reconstruction with soft tissue free flaps for large defects after the resection of giant facial neurofibroma

Publication date: Available online 18 December 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): L. Hu, Y. Xi, Y. Wang, L. Jiannan, J. Han, Y. Miao, S. Gokavarapu, C. Zhang, L. Xu
Giant facial neurofibroma leads to disfigurement and functional and neurological deficits. Surgical resection is the mainstay of treatment and poses a great challenge to the surgeon with regard to the restoration of the defects arising from tumour resection. The cases of three male and three female patients diagnosed with giant facial neurofibroma, who underwent radical resection and reconstruction with soft tissue free flaps between 2008 and 2015, were analyzed retrospectively. Clinical data including patient sex, age, preoperative embolization of the nutrient artery, volume of blood loss, type and size of flaps used for reconstruction, and complications were recorded. Three of the six patients underwent preoperative embolization of the nutrient artery. The average volume of blood loss was 2850ml. Reconstruction was performed with anterolateral thigh flaps in four patients and latissimus dorsi myocutaneous flaps in two patients. All free flap reconstructions were successful. Partial necrosis of the scalp and wound dehiscence occurred in one patient each. All complications were managed successfully. In conclusion, the soft tissue free flap is a good choice for the coverage of defects after giant facial neurofibroma resection. Multi-disciplinary treatment should be strengthened to minimize the risks of complications, as well as improving quality of life.



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