胸大肌肌皮瓣在晚期头颈肿瘤手术缺损重建中的应用

Pectoralis Major Myocutaneous Flap for Reconstruction of Defects in Advanced Head and Neck Tumors

目的 总结胸大肌肌皮瓣在晚期头颈肿瘤手术缺损重建中的应用。方法 回顾性总结1988年1 月1日～2003年12月31日14例在我科因头颈部肿瘤手术后巨大组织缺损应用胸大肌肌皮瓣进行修复的临 床资料。结果 肌皮瓣全部成活13例,1例肌皮瓣远端部分坏死,经换药后愈合。1例与受区组织伤口部分 裂开,换药处理后愈合;1例胸部皮下积液,经穿刺抽液后消失。成活胸大肌肌皮瓣色泽良好,但多显有些臃 肿。结论 胸大肌肌皮瓣是一种非常实用而优良的修复材料。它具有丰富的组织量,优良的血液供应,且与 头颈部邻近,在多种情况下可以应用,特别适用于头颈部肿瘤扩大切除术后缺损的即刻修复重建。

Objective To evaluate the efficiency of the pectoralis major myocutaneous flap for reconstruction of defects in advanced head and neck tumors.Methods Between January 1998 and December 2003, 14 cases with advanced head and neck tumors, who were applied pectoralis major myocutaneous flap ( PMMF) for reconstruction the defects in our hospital, were included in this study. Three of the cases were female and 11 were male. Their ages were between 19~66. All of the cases were reconstructed with PMMF in the same operation after the tumor resection. PMMF was used for the reconstruction of defects in the face or neck in 9 cases, for the reconstruction of oropharynx and hypopharynx in 3 cases, for reconstruction of the tongue and tongue base in 2 cases. PMMF was transfered to the recipient sites through the neck dissection wound in 9 cases, through the subcutaneous tunnel of the neck in 5cases.Results In our series of 14 cases, partial necrosis was found in one case. The flap suture line at recipient site was opened in one case. Subcutaneous seroma was found in donor site at one case. The three cases with the aboue problems were cured with different managements. Conclusion Pectoralis major myocutaneous flap is a functional and reliable choice for reconstruction of defects in the advanced head and neck tumors.