应用胸大肌岛状肌皮瓣重建全舌体、口底的初步报告

An island pectoralis major myocutaneous flap for the reconstruction of tongue and floor of mouth

目的 探讨累及双侧的舌癌根治术后全舌体、口底重建的有效方法及临床评价。方法 对 2 0 0 0年 10月至 2 0 0 2年 12月间我科收治的 7例累及双侧的舌癌患者实施根治性手术 ,造成全舌体、口底的大面积缺损 ,采用一侧胸大肌岛状肌皮瓣转移即时重建全舌体和双侧口底。结果 6例转移肌皮瓣完全成活 ,口腔和颈、胸部创面均一期愈合。 1例肌皮瓣远端部分皮肤坏死 ,但无口底颌下瘘和感染等并发症发生。术后随访 2～ 16个月 ,重建舌体、口底形态基本满意 ,语言功能大部分恢复 ,吞咽功能恢复良好。 1例在术后 9个月死于肿瘤肺转移 ,其余 6例目前均健在。结论 胸大肌岛状肌皮瓣组织量大 ,血供丰富 ,是全舌体、口底重建的理想选择。

Objective To evaluate an island pectoralis major myocutaneous flap for immediate reconstruction of the total tongue body and the floor of the mouth after radical resection of bilateral tongue carcinoma involved. Methods Form October 2000 to December 2002, seven patients with bilateral tongue carcinoma were selected to treat with salvage surgery, and an island pectoralis major myocutaneous flap were applied for immediate reconstruction of total body of tongue and floor of mouth. Results Six flaps survived well. Only one flap showed a partial necrosis, with no submandibular fistula, infection, and other complications. The reconstructed tongue and floor of mouth worked well. The speaking and swallowing functions were satisfactory after 2～16 months' follow-ups. Only one patient died of lung metastasis carcinoma in 9 months after the operation. Conclusions The island pectoralis major myocutaneous flap could be an ideal selection for the immediate reconstruction of the total tongue body and the floor of mouth.;