应用下蒂型斜方肌皮瓣修复放射性骨坏死致口腔面颈部软组织缺损

The clinical use of inferiorly pedicled trapezius flap in reconstruction of oral-maxillofical-cervical defects due to radionecrosis of the jaws

目的:采用下蒂型斜方肌肌皮瓣修复放射性骨坏死致口腔面颈部软组织缺损,评价其临床效果。方法:在对斜方肌及其血供进行显微外科解剖学研究的基础上,利用颈横动脉浅降支为蒂,设计下蒂型斜方肌皮瓣,皮瓣转移修复因放射性骨坏死致口腔、颌面及上颈部软组织缺损9例,共11侧。术后随访1～6个月,观察皮瓣生长情况和患者张口度的变化。结果:临床应用该肌皮瓣修复口腔、颌面及颈部组织缺损9例,其中2例采用双侧肌皮瓣转移修复,除1块皮瓣远端部分表皮坏死外,其余皮瓣均完全成活,且术后患者张口度最大者增加2.5cm。结论:下蒂型斜方肌皮瓣修复口腔、颌面及上颈部组织缺损的效果良好,成功率高,方法可靠,操作简单,是一种治疗颌骨放射性骨坏死的理想方法。

PURPOSE: The purpose of this study was to explore the clinical use of inferiorly pedicled trapezius flap in reconstruction of oral-maxillofacial-cervical defects due to because of osteoradionecrosis of the mandible and to prove that this was an effective method to restore the defects. METHODS: 9 cases of oral-maxillofacial-cervical defects were restored with the inferiorly pedicled trapezius flaps.The patients were followed up from 1 to 6 months after operations and investigated the survival of the flaps and the variety of the patients' mouth opening. RESULTS: The inferiorly pedicled trapezius flaps were applied clinically in 9 cases. In 2 cases, bilateral inferiorly pedicled trapezius flaps were used to restore the defects. It was found that 1 flap was necrosed in the distal end ,another 8 flaps survived. CONCLUSION: Inferiorly pedicled trapezius flap is ideal in one-stage repair of the oral-maxillofacial-vertical defects.