Microsurgical autotransplantation of the large omentum in a patient with Parry – Romberg syndrome: Case report

Abstract

BACKGROUND: Parry Romberg syndrome or progressive hemifacial atrophy is a rare disease that is usually unilateral with soft and hard tissue atrophy. Surgical treatment is conducted in different ways and only with pronounced cosmetic and functional defects. Currently, no randomized trials and clinical recommendations are reported on the choice of surgical methods of Parry Romberg syndrome intervention.
 AIM: This study aimed to evaluate the effectiveness of the microsurgical method for correcting facial cosmetic defects in Parry Romberg syndrome.
 CASE REPORT: Clinical signs of Parry Romberg syndrome appeared in a boy from the age of 11 years. The ongoing conservative treatment could not prevent the progression of atrophy of the right half of the face. At 16 years old, he underwent a microsurgical operation, the technique of which was as follows: a graft of the greater omentum on a vascular pedicle was laparoscopically taken from the abdominal cavity and placed in a prepared bed under the right cheek skin with an anastomosis formation of the temporal artery. The postoperative period was without complications. At the age of 2 and 4 years, small defects were eliminated by 2 ml lipofilling. The vascularized flap had a positive effect on the trophism of the surrounding tissues, and skin elasticity and color were completely restored. Currently, 9 years after the operation, the cosmetic results are good, and the patient does not experience psychological discomfort. Herein, presented the data of computed tomography, patient photographs, and operation stages.
 CONCLUSION: The presented clinical case of a microsurgical operation by autotransplantation of the greater omentum in a patient with Parry Romberg syndrome shows the effectiveness of this method, which was confirmed by a 9-year follow-up period.