带颈横血管上斜方肌肌皮瓣即刻修复舌癌术后缺损21例报道

Immediate repair of tongue defects by superior trapezius myocutaneous flap with transverse cervical artery

目的:研究以颈横动脉为蒂的上斜方肌肌皮瓣修复舌癌术后舌缺损的临床效果。方法:1994年9月～2004年4月期间,对21例经病理确诊的舌癌患者均行根治性颈清术,术中采用以颈横血管为蒂的上斜方肌肌皮瓣同期修复舌缺损。供区创面直接拉拢缝合,未行植皮。结果:21例皮瓣全部成活,仅1例出现部分坏死。术后早期再造舌外形和功能都较差,3个月～1a后,形态上出现黏膜化,语言、咀嚼和吞咽功能逐渐改善。结论:以颈横动脉为蒂的上斜方肌肌皮瓣是修复舌缺损的优良皮瓣之一。

PURPOSE： To evaluate the clinical effects of the superior trapezius myocutaneous （STM）flap with the transverse cervical artery （TCA）in the repair of the tongue defects immediately after the neck dissection of tongue carcinoma. METHODS： From September 1994 to April 2004, 21 cases with tongue carcinoma got radical neck dissection in our department. All the tongue defects have been repaired immediately by the STM with the TCA. The donor site was closed primarily after harvest without skin graft. RESULTS： All flaps survived, with only one flap partly infarcted, the success rate was 100%. Primarily, the morphology and the function of the reconstructed tongues were dissatisfactory. But 3 months to 1 year later, the tongues became mucolized, the speech, chewing and swallowing functions were improved. CONCLUSIONS： The STM with TCA was one of the satisfactory flaps for reconstructing the tongue defects.