双皮岛游离腓骨瓣修复口腔颌面部复合缺损

A review of 12 cases of double-skin paddle free fibula flap transfers for head and neck reconstruction

目的 探讨双皮岛游离腓骨瓣在口腔颌面部复合缺损修复中的可靠性和应用价值。方法 2 0 0 0年9月至 2 0 0 3年 2月完成的 12例双皮岛游离腓骨瓣移植修复口腔颌面部缺损的病例 ,分析缺损的类型、所采用腓骨瓣的设计、皮岛的大小、血供来源、皮岛的作用、皮岛的成活情况及并发症的发生情况。结果 12例腓骨瓣中 ,9例用于下颌骨缺损的修复 ,3例用于上颌骨缺损的修复 ,2 4块皮岛均由腓动脉的隔皮穿支供血 ,其中 10块皮岛用于口内缺损的修复 ,6块用于口外缺损的修复 ,4块用于组织充填 ,2块用于鼻腔粘膜缺损的修复 ,2块用于腓骨瓣血供的监测。全部游离组织瓣均获得成活 ,无一例发生坏死和部分坏死 ,全部 2 4块皮岛均获得 10 0 %成活 ,受区和供区总的并发症发生率为 33.3%。结论 双皮岛游离腓骨瓣提高了游离腓骨瓣的修复效能和效果 ,在口腔颌面部复合缺损的修复中具有很大的灵活性 ,其安全可靠 ,制备简便 ,供区并发症少 。

Objective To analyze the value and feasibility of head and neck reconstruction using double-skin paddle free fibula flap.Methods Twelve cases of double-skin paddle free fibula flap transfers performed from September 2000 to February 2003 were reviewed.Data concerning the operation included defect description and site,stage and histology of tumor,design of free fibula flap and skin paddle,recipient vessel and type of anastomosis used and complications was analyzed.Results Among the 12 free fibula flaps,9 were used for mandibular reconstruction,3 were used for maxillary reconstruction.All the 24 skin paddles were supply by septocutaneous perforators.Ten skin paddles were used for intra-oral reconstruction,6 for extra-oral reconstruction,4 for tissue augumentation,2 for nasal mucosa reconstruction,and 2 for monitoring blood flow of fibula flap.All free fibula flaps with all skin paddles survived completely,with the overall success rate of 100%.Conclusion Double-skin paddle free fibula flap is a versatile and reliable free flap for reconstruction of complex head and neck defects.