自体舌肌黏膜瓣转移修复舌尖缺损

Reconstruction of lingual tip defects with autologous lingual muscular-mucosa flap transfer

目的探讨采用自体舌肌黏膜瓣对舌尖缺损进行修复的临床效果。方法对5例舌尖的外伤及血管瘤、淋巴瘤切除后造成缺损的患者,根据缺损面积(1.0 cm×1.5 cm～2.0 cm×3.5 cm)于舌尖缺损的同侧舌体部位设计舌肌黏膜瓣的大小,切开黏膜、舌肌后,结合锐、钝性分离形成舌肌黏膜瓣,然后直接滑行或通过隧道以岛状瓣的方式转移修复缺损区。结果自2004年1月至2005年11月,采用本方法修复的5例患者,伤口均Ⅰ期愈合,舌肌黏膜瓣成活良好。术后经3个月至2年的随访,无并发症发生,舌尖形态满意,发音及吞咽均正常。结论自体舌肌黏膜瓣修复舌尖缺损是一种可供临床选择的良好方法。

Objective To explore the clinical result of application of an autologous lingual muscular- mucosa flap to the lingual tip defect. Methods Five patients with tongue- tip defects causded by injuries, or by resection of hemangioma or lyrnphoma underwent surgical repair by sharp and blunt dissection of mucosa and lingual muscle to establish lingual muscular- mucosa flaps. These flaps as the flaps as the island flap were transferred to the defect area by sliding them directly or thought a tunnel, according to the size of the defect （1.0 cm× 1.5 cm-- 2.0 cm × 3.5 cm）. Results Between January 2004 to November 2005, all 5 patients who had this procedure performed showed good primary healing, and all flaps were viable. After 3- 24 months follow- up postoperatively, all patients were satisfied, and there were no complications. The lingual tip contour was satisfactory, and patients exhibited normal speech characteristics and deglutition. Conclusion This technique using an autologous lingual muscular- mucosa flap is a good clinical method for patients with a lingual tip defect.