颈部瘢痕挛缩松解术中颌颈角的形成及意义

Study on the Formation of Cervico-Mandibular Angle in the Reconstruction of Neck Scar Contracture

目的探讨颈部瘢痕挛缩松解术中形成颌颈角的方法及其临床意义。方法43例颈部瘢痕挛缩患者,在彻底松解瘢痕挛缩的基础上,根据患者的具体情况,分别采用游离植皮、颈阔肌软组织瓣加深颌颈角、游离皮瓣移植、分叶皮瓣游离移植及颏骨截骨前移、颏成形等方法修复创面,重塑颈部曲线。结果手术效果良好,术后颌颈角明显,颈部曲线恢复,其中21例患者术后6个月随访,颌颈角仍然明显,无再次挛缩出现。结论形成颌颈角是颈部瘢痕挛缩松解术成功的关键,其对维持颈部外形和功能有重要作用。

Objective To explore the methods and significance of cervico-mandibular angle formation in the reconstruction of neck scar contracture. Methods Forty-three patients with cervical scar contracture deformity were repaired by free skin graft, platysma flap graft to deepen the cervico-mandibular angle, single free flap graft, doublelobe free flap graft, and mentoplasty after cervical scar resection. Results All patients were satisfactory with marked cervico-mandibular angle and function restoration after the operations, and 21 cases still had visible cervicomandibular angle without secondum contracture after 6 months follow up. Conclusion The cervico-mandibular angle is significant for both the appearance and function of the neck, and cervico-mandibular angle formation is a key point in the reconstruction of neck scar contracture.