颊肌黏膜瓣在宽大红唇及口轮匝肌缺损修复中的应用

Buccal musculomucosal flap for reconstruction of wide vermilion and orbicularis oris muscle defect v

目的探讨修复大面积的红唇及口轮匝肌缺损的手术方法。方法设计以面动脉前颊支为血管蒂的颊肌黏膜瓣,用以修复上或下唇宽大的红唇及口轮匝肌缺损。结果共治疗7例,5例患者术后无任何并发症,2例患者颊肌黏膜瓣尖端黏膜坏死,未累及肌层,术后创面通过黏膜上皮化而愈合,无其他并发症发生。术后早期即可测到温度觉、触觉,肌电图和电镜显示瓣内肌肉有运动神经支配。结论应用颊肌黏膜瓣可以修复用常规方法难以解决的宽大红唇及口轮匝肌缺损,并且可获得良好的形态、感觉和功能。

Objective To investigate the reconstruction of wide vermilion and orbicularis oris muscle defect with satisfactory outcome of aesthetics, sensation, and function. Methods The buccal musculomucosal flap based on the anterior buccal branches of the facial artery was used to reconstruct wide defect of vermilion and orbicularis oris muscle on upper or lower lip. Results 7 patients were treated. 5 cases had no postoperative complication. Partial mucosal necrosis on the tip of the flaps happened in 2 cases, but the underlying muscle survived and was re-mucosalized spontaneously. No other complication was observed. The sensation of cold, heat and touch could be detected on the first postoperative day. Electromyographic and electron microscopic studies confirmed innervation of the muscle in the flap. Conclusions The buccal musculomucosal flap is a reliable reconstruction option for wide defect of vermilion and orbicularis oris muscle which can＇t be reconstructed with conventional method. Satisfactory aesthetic and functional results can be achieved with the buccal musculomucosal flap.