邻近带蒂肌皮瓣整复口腔癌术后组织缺损

Pediculated Myocutaneous Flaps in Reconstruction of Oral Defect Caused by Tumor Resection

目的探讨邻近带蒂肌皮瓣即刻整复口腔癌术后组织缺损的方法和适应症,提高患者生活质量。方法应用颈阔肌肌皮瓣、胸锁乳突肌肌皮瓣、上斜方肌肌皮瓣即刻整复口腔癌术后组织缺损68例,术后观察组织瓣成活情况和口腔功能恢复情况。结果68例中64例肌皮瓣全部成活,Ⅰ期成活率94·1%。3例肌皮瓣发生远端部分坏死,1例出现感染,经换药肉芽组织生长修复。术后经1～5年随访,外形、功能均满意。结论3种邻近带蒂肌皮瓣制作简便,成活率高,效果满意。临床应用主要根据肿瘤部位、缺损范围等进行选择。

Objective To discuss the methods and indications of using pediculated myocutaneous flaps to reconstruct the oral and maxillofacial defect that results from the resection of oral carcinoma. Methods To use three kinds of pediculated myocutaneous flaps： platysma, sternocleidomastoid musle and superior trapezius myocutaneous flaps for repairing and reconstructing the tissue defects in 68 cases with oral carcinoma. Results 64 myocutaneous flaps were transplanted successfully, I stage survival rate was 94. 1%. Partial necrosis in termination of the flaps in 3 cases, infection in 1 case, and finally restored with granulation. The results were satisfactory after 1 to 5 years follow - up. Conclusion It is simple and convenient, with higher success rate and satisfactory efficiency to use the three flaps. It is important to choose projects according to tumor region and defect range.