不同类型的颈阔肌肌皮瓣存活情况的临床分析

Clinical analysis about survival condition of different types of platysma myocutaneous flaps

目的分析54例不同类型的颈阔肌肌皮瓣修复口腔癌口内组织缺损的效果,以指导临床实践。方法12例应用横向型颈阔肌肌皮瓣,42例为纵向型颈阔肌肌皮瓣;42例纵向型颈阔肌肌皮瓣中26例保留颌外动脉及面前静脉,16例未保留,比较各类型肌皮瓣的存活情况。结果12例横向型颈阔肌肌皮瓣中10例完全存活,2例出现远端部分坏死;26例纵向型保留颌外动脉及面前静脉的颈阔肌肌皮瓣中23例完全存活,3例出现远端部分坏死;16例未保留颌外动脉及面前静脉的纵向型颈阔肌肌皮瓣中10例完全存活,4例出现远端部分坏死,2例完全坏死。结论纵向型未保留颌外动脉及面前静脉的颈阔肌肌皮瓣存活率较低,临床应用时应慎重选择适应证。

Objective To compare the postoperative outcome among different types of platysma myocutaneous flaps by reviewing 54 cases. Methods From 1984 to 2004, 54 patients with oral cancer underwent immediate reconstruction of intraoral defects using the platysma myocutaneous flaps. In 54 cases, 12 cases were transversal platysma myocutaneous flaps and the other 42 cases were vertical platysma myocutaneous flaps. In these 42 cases, 26 cases preserved facial artery and vein yet 16 cases didn＇t preserve them. The survival condition of these flaps were compared. Results In the 12 cases of transversal platysma myocutaneous flaps, 10 cases survived totally and 2 cases had partial necrosis. In the 26 cases of vertical platysma myocutaneous flaps preserved facial artery and vein, 23 cases survived completely and 3 cases had partial necrosis. However, in the 16 cases of vertical platysma myocutaneous flaps in that facial arterys and veins were not preserved, 10 cases survived completely, whereas 4 cases had partial necrosis and 2 cases had complete necrosis. Conclusions The survival rates of platysma myocutaneous flaps that didn＇ t preserve facial artery and vein were low. Its clinical use should be prudent.