应用改良带蒂胸大肌肌皮瓣修复口腔颌面肿瘤术后缺损

The operative defects of applying the improved pedicle ectopectoralis musculocutaneous flaps to recover the oral occlusalf surface tumor

目的探讨改良胸大肌肌皮瓣的制作方法及转移修复口腔颌面缺损的效果。方法对本院2002-2008年采用改良胸大肌肌皮瓣的病例进行回顾性分析。结果17例患者中，术后15例皮瓣全部成活，1例部分胸大肌肌皮瓣尖端坏死（不超过皮瓣面积8％），1例胸大肌肌皮瓣坏死约25％最后经换药愈合。随访10个月～5年，其中5例因肿瘤复发及其它原因死亡，其余12例均健在，术后功能、外观比较满意。结论改良胸大肌肌皮瓣是修复口腔颌面颈部组织缺损的理想肌皮瓣，符合近年来功能外科的要求。

Objective To investigate the processes of improving the ectopectoralis musculocutaneous flaps and the effectiveness of transferring and recovering the oral occlusalf surface defectiveness. Methods To analyze retrospectively the cases adopted by improved ectopectoralis musculocutaneous flaps from 2002 to 2008 in our hospital. Results Of the 17 patients, the skin flaps of 15 survives; one top ectopectoralis musculocutaneous flap necrotizes（ no more than 8% of the total skin flap area） ; 25% of one＇ s ectopectoralis musculocutaneous flap necrotizes but it heals after changing dressings. During 10 months to 5 years＇ visit,5 patients die of tumor recurrence or other reasons; and the left survives and the functions and appearances are satisfactory after operation. Conclusion The improved ectopectoralis musculocutaneous flap is the ideal musculocutaneous flap in recovering oral occlusalf surface defectiveness and it meets the demands of recent functional surgery.