舌侧缘瓣修复红唇部缺损

Reconstruction of lip defects with lingual membrane flaps

目的 采用舌侧缘瓣移植 ,修复红唇部缺损畸形。方法 对 1 1例红唇部完全或部分缺损患者 ,根据缺损范围大小制备取蒂在舌尖部的双侧或单侧舌侧缘瓣 ,转移至红唇部缺损区 ,2周后断蒂 ,恢复红唇外形 ,其中有 4例为唇部复合缺损患者 ,先行红唇部以外复合组织的修复 ,再行红唇部的修复。有 4例红唇缺损范围均超过唇全长 1 / 2 ,采用了双侧舌瓣修复法 ,其余 7例 ,红唇缺损范围均小于 1 / 2 ,则采用单侧舌瓣修复法。结果 所有病例 ,舌瓣全部成活 ;红唇部外形、色泽及功能恢复较好 ,无舌运动受限 ,无感觉及味觉减退等症状。结论 采用舌侧缘瓣修复法 ,尤其是双侧舌瓣修复法 ,能即时修复红唇部大范围缺损 ,无需分两次转瓣修复。舌瓣能提供较好颜色和丰满度 ,在最大程度上保留了舌黏膜乳头 ,无损于术后舌部的味觉功能 ;舌部供区隐蔽 ,术后不留明显畸形 ,对舌功能影响不大。

Objective To study the reconstruction of lip defects by using lingual membrane flaps. Methods 11 cases were presented, whose lip defects were extensively or partially. According to the size of defects, bilateral and lateral lingual membrane flaps were transfered to cover the defects to rebuild the lip contour, and then the posteriors were cut 2 weeks later. The repair of lip defects were done after the cover of region outside of lip in 4 patients who had composite defects. 4 patients underwent bilateral lingual membrane flap for repair of lip defects over 1/2 width of lip. 7 patients whose lip defects were less than 1/2 width of lip underwent lateral lingual membrane flap for repair. Results all the flaps were survival. The contour, color and function of lips were reconstructed well. The feeling, taste and movement of the tongue were normal. Conclusion Using lingual membrane flap to close the large defect of lip requires only one operation, especially in the defect repair with bilateral lingual membrane flaps. The flaps can not only rebuild the lip color and contour, but also remain enough tongue papilla in order to ensure the tongue taste after the operation. The excision in the tongue is hidden and tongue's function and contour can be little affected.