Yu Maruyama

Treatment of pigmentation of the lips and oral mucosa in Peutz-Jeghers' syndrome using ruby and argon lasers

Three patients with punctate pigmented spots on the lips and oral mucosa, accompanying the P-J Syndrome, were successfully treated with ruby and argon lasers. The basic principles of laser treatment, the characteristics of the different laser systems and the skin reaction to ruby and argon lasers are discussed.

A gluteus maximus myocutaneous island flap for the repair of a sacral decubitus ulcer

The gluteus maximus myocutaneous island flap is a useful, safe and versatile flap for the repair of sacral decubitus ulcers. It is now our recommended procedure of choice for the surgical treatment of this type of wound (Maruyama and Tajima, 1978).

The definition of cutaneous vascular territories over the back using selective angiography and the intra-arterial injection of prostaglandin E1: some observations on the use of the lower trapezius myocutaneous flap.

The lower trapezius myocutaneous flap based on the descending branch of the transverse cervical artery is particularly useful in the repair of defects over the back, shoulder and scalp region. Three illustrative examples are given of the use of this particular flap. The precise definition of the vascular territory in the overlying skin can be shown by selective angiography and intra-arterial injection of PGE 1. An axial vascular territorial map has been constructed to show the anatomical distribution of the various dominant areas that supply the skin over the back.

Double-folded free myocutaneous flap to cover a total cheek defect

This is a report of the successful reconstruction in two cases of a total cheek defect after radical maxillectomy with orbital exenteration for cancer of the maxillary sinus, in one stage, utilizing a double-folded free latissimus dorsi myocutaneous flap. The importance of preoperative angiography to identify suitable donor vessels, and of microneurovascular anastomosis to maintain the normal function of the transplanted muscle is stressed.

Deltovertebral flap to cover a large scalp defect: case report.

A deltovertebral flap based on the perforating cutaneous branches of the posterior intercostal vessels (the exact opposite of the deltopectoral flap) was used successfully to cover a large scalp defect. The procedure is a rather hazardous one, due to the numerous stages and the awkward postoperative position. However, it may be used to repair the lateral aspect of the neck or the occipital region when a flap is necessary and other methods are not feasible.

A dynamic reconstruction of a facial defect with a pectoralis major myocutaneous flap

The surgical reconstruction of major defects of the cheek such as those following cancer surgery or accidental injury, is usually performed using static components (McGregor and Reid, 1970). Recent developments in microsurgery and particularly the use of the myocutaneous flap, have introduced a new dimension in the dynamic reconstruction of facial defects (Manktelow, 1979). We have successfully used the latissimus dorsi neurovascular myocutaneous flap as a free flap for dynamic facial reconstruction in 2 patients with cheek defects (Maruyama ef ai., 1979). However, the reconstruction by microvascular anastomosis is a somewhat complicated and time-consuming procedure and free flap transfer has not yet proved to be thoroughly reliable, as its success always depends on two small vessel anastomoses. We present a patient in whom a pectoralis major ne~ov~cul~ pedicled myocutaneous flap was successfully transferred to fill a soft tissue defect of the cheek and combined with a selective neuro-anastomosis to provide dynamic muscle action.

The use of lower trapezius myocutaneous island flaps in head and neck reconstruction

Abstract The lower portion of the trapezius muscle can be designed as an island myocutaneous flap and has certain advantages when compared with the more familiar upper trapezius myocutaneous flap. Several authors have reported the use of trapezius myocutaneous flaps usually based on the upper portion of the trapezius muscle: McCrawet al. (1979); Lamberty (1979); Mathes and Nahai (1979); Bertotti (1980). We have previously reported the use of the lower portion of the trapezius muscle as a myocutaneous flap in head and neck reconstruction (Maruyamaet al., 1981) and now wish to report its adaptation as an island flap in two patients.

Primary functional cheek reconstruction: a case report.

A primary functional reconstruction of the cheek defect aRer resec{ion of an early malignant tumour in the young adult is highly desirable for both aesthetic and psychological reasons. Despite the postoperati,c administration of cytotoxic anti-cancer ageuts, we have successfully transferred by microneurovascular anastomosis a free re-innervated lalissimus dorsi myocutaneous flap in one patient with a satisfactory functional result. A 20-year-old girl student was referred to us with a malignant lesion of the left check of short duration. Histological examination of a bioi~sy specimen had shown a low grade fibro-sa1coma of the soft tissues and skin. The extent of the tumour and the planned excision of the lesion is shown (l:ig. 1). A wide en bloc resection of the cheek lesion was carried out, together with the underlying facial muscles and the branches of the facial nerve (Fig. 2). Frozen sections of tim excised specimen showed complete removal of Ibe lesion

The value of Prostaglandin E1 and selective angiography in the territorial definition of axial pattern flaps of the buttock

The definition of the cutaneous vascular territory in axial pattern flaps has been studied by intravital injection of dye or fluorescein, or by post mortem dissections and injection. This paper illustrates the use of selective angiography and the intra-arterial injection of Prostaglandin E1 in the definition of axial pattern flaps in the buttock. The technique is safe, with no side effects and can be repeated. Its clinical application in the discovery and selection of axial pattern flaps is obvious.

Primary reconstruction of perineal defect with a bilobed myocutaneous flap: Case report

Abstract After radical abdomino-perineal excision for carcinoma of the ano-rectal region a successful primary reconstruction can make all the difference to the physical and functional well being of the patient, quite apart from shortening the period of stay in hospital. The versatility of the myocutaneous flap is now well recognised and in this case report we describe a one-stage repair of a large perineal defect using a bilobed flap which combines the inferior gluteus maximus myocutaneous flap and the tensor fasciae latae myocutaneous flap.