游离股前外侧皮瓣修复腮腺恶性肿瘤术后缺损12例效果评价

Evaluation of the value of free anterolateral thigh flap in repairing postoperative defects of parotid gland malignant tumors

目的:探讨游离股前外侧皮瓣修复腮腺恶性肿瘤术后缺损的效果。方法:选择2019年1月—2022年12月徐州市中心医院收治的12例采用股前外侧皮瓣修复腮腺恶性肿瘤术后缺损的患者。手术切除肿瘤组织后,根据腮腺区缺损面积及外形,设计和制备股前外侧皮瓣,修复肿瘤切除后的组织缺损。术后随访观察患者皮瓣成活、外观恢复情况、患侧面部表情肌功能及患者满意度。采用SPSS 20.0软件包对数据进行统计学分析。结果:术后皮瓣均成活良好,缺损均得到有效修复。术后1个月,患者皮瓣与周边皮肤组织厚度、色泽无明显差异,无牵拉及不对称,外观修复效果满意,满意度为83.33%。9例患者术后患侧面部表情肌功能较术前减弱,3例患者术前即出现面瘫症状,术后患侧面部表情肌功能较术前未见改善。结论:游离股前外侧皮瓣修复腮腺恶性肿瘤术后缺损效果满意,皮瓣美观,患者术后满意度高,且供区隐蔽,自身创伤小,具有一定实用价值。但腮腺恶性肿瘤术后患侧面部表情肌失神经支配,通过游离股前外侧皮瓣的个性化设计修复,患侧面部表情肌功能无明显改善。

PURPOSE:To investigate the effect of free anterolateral thigh(ALT)flap for repairing postoperative defects in parotid gland malignant tumors.METHODS:Twelve patients who underwent repair of postoperative defects in parotid gland malignant tumors using ALT flap were admitted in Xuzhou Central Hospital from January 2019 to December 2022.The ALT flap was designed and prepared based on the area and shape of the parotid gland defect to repair tissue defect after tumor resection.The patient's flap survival,appearance recovery,facial expression muscle function on the affected side,and patient satisfaction after surgery were observed.SPSS 20.0 software package was used to analyze the data.RESULTS:All the flaps survived smoothly and the defects were effectively repaired.There was no significant difference in thickness or color between the flap and the surrounding skin tissue,no traction or asymmetry one month after surgery.The appearance and functional repair effect were satisfactory,with a satisfaction rate of 83.33%.Nine patients had weakened facial expression muscle function on the affected side after surgery,while three patients had symptoms of facial paralysis before surgery had no improvement in facial expression muscle function on the affected side after surgery.CONCLUSIONS:The ALT flap for repairing postoperative defects in parotid gland malignant tumors has satisfactory results,and the donor site is concealed with minimal self trauma,therefore,it is worthy of clinical application.However,after surgery for parotid gland malignant tumors,the facial expression muscles on the affected side were denervated,and personalized design and repair with a free ALT flap did not significantly improve the function of the facial expression muscles on the affected side.