摘要
1984年9月～1987年6月,作者又应用舌骨下肌皮瓣86个完成另一组86例头颈部恶性肿瘤根治术后缺损的立即修复。认为应用该肌皮瓣时年龄可放宽。修复部位可扩大到口咽和喉咽。保存发自甲状腺上动脉的胸锁乳突肌支和颈阔肌直接皮肤支有助于舌骨下肌皮瓣的成活。有指征时可将舌骨平面以下的胸锁乳突肌包括在舌骨下肌皮瓣内从而确保上述两肌支不受损。当肌皮瓣发生静脉血循障碍时,结扎与甲状腺上静脉争流抢道的颈内静脉颅侧段以及其他静脉如舌、咽、面总等静脉是挽救皮瓣的另一有效方法。全舌修复者补加喉悬吊术有利舌咽与说话功能的补偿。用胸横筋膜皮瓣修复颈前供区既简化操作又改善外形。
From Sept 1984 to June 1987, infrahyoid myocutaneous flap (IHMCF) were used for immediate reconstruction after radical resection of head and neck cancer in 86 patients after our previous report. Our new experiences were: (1) IHMCF can repair not only the defects in or around the oral cavity but also the defects in the hard palateoro-pharynx or hypopharynx. (2) Preservation of the sternocleidomastoid branch and the direct cutaneous branch of the superior thyroid artery going to the platysma increased flap survival. (3) When the flap lost its normal color, ligation of pharyngeal, lingual and common facial vein would increase pedical venous flow of the IHMCF, (4) Laryngeal suspension allowed the patients with total tongue reconstruction better function of swallowing and speech. (5) Using transverse pectoral fasciocutaneous flap to repair the defect after IHMCF transfer could simplify operation and yield more satisfactory cosmetic appearance of the neck.
出处
《上海医学》
CAS
CSCD
北大核心
1989年第3期144-148,共5页
Shanghai Medical Journal
