应用颏下皮瓣修复下咽癌术后缺损的临床探讨

Submental flap for repair of postoperative defects in hypopharyngeal carcinoma patients

目的 探讨颏下皮瓣修复下咽癌术后缺损和喉功能重建的临床价值。方法 应用颏下皮瓣修复下咽癌术后缺损及喉功能重建术16例。结果 术后16例皮瓣全部成活。病人吞咽及发音功能恢复良好，11例病人拔除气管套管，5例未拔管。随访1～4．5年，2例术后同侧颈部淋巴结复发，1例术后对侧颈部淋巴结复发，1例术后1年肝转移死亡；无下咽局部复发者。结论 颏下皮瓣具有位置邻近、厚薄适宜、柔软、成活率高等优点，是适宜的下咽缺损修复材料。

Objective To study the clinical application of submental flap for repair of postoperative defects and reconstruction of the the laryngeal function in hypopharyngeal carcinoma patients. Methods The submental flap was applied to repair postoperative defects and to reconstruct the laryngeal function in 16 patients suffering from hypopharyngeal carcinoma. All the cases were followed up for 12 to 54 months postoperatively. Results The flaps kept alive in all 16 cases. Of them, 11 cases were detubelized and laryngeal functions （voice, respiration and deglutition） were totally preserved. Lymph node recurrence occurred at the ipsilateral neck side in 2 patients and contralateral side in 1. One patient died of liver metastasis 12 months after operation. No local hypopharyngeal recurrence occurred. Conclusion With suitable thickness, sofmess, high alive rate, fewer disturbance to donor area, submental flap is an ideal tissue flap for the repair of the postoperative defects and reconstruction of the the laryngeal function in hypopharyngeal carcinoma patients.