3种肌(皮)瓣在口腔颌面部缺损修复中的应用

The application of the different flaps in the reconstruction repair of oral and maxillofacial defects

目的:探讨3种肌(皮)瓣移植在口腔颌面部组织缺损修复中的临床效果和适应证。方法:对28例口腔颌面部组织缺损患者分别采用前臂皮瓣、胸大肌肌皮瓣、额瓣进行移植修复。结果:28例中完全成活25例,大部分成活1例,移植成功率为92.8%,完全坏死2例,部分坏死1例;前臂皮瓣全部成活13例,全部坏死1例;胸大肌肌皮瓣全部成活10例,部分坏死1例,全部坏死1例;2例额瓣全部成活。颌而部外形、丰满度及表情功能恢复良好,口腔功能明显改善。结论:3种肌(皮)瓣均可较好地修复口腔颌面部的组织缺损,但应根据缺损的组织量、部位、缺损范围选用不同的组织瓣。

Objective： To evaluate the clinical effects and indications of the three cutaneous or myocutaneous flaps in the reconstruction of oral and maxillofaeial defects. Methods： The oral maxillofaeial defects of 28 cases were reconstructed by peetoralis major myocutaneous flap, forehead flap and forearm flap. Results. In 28 reconstructive sites, 25 were survived completely, 2 were total necrotic and one was partial necrotic. Among the sites reconstructed by the forearm flaps. 13 were survived completely and one was total neerotic; among the sites reconstructed by pectoralis major myoeutaneous flap, 10 were survived, one was partial necrotic and one was total necrotic. Two sites reconstructed by forehead flap were survived completely. Conclusion： It may be good method to use the three different flaps to repair the oral and maxillofical defects to get the better functional and contour effects, but the selection of the different flaps is based on the range, the location and the amount of the defect.