颏部岛状组织瓣功能性修复全下唇缺损的临床观察

Functional reconstruction of total lower lip defect with mental neurovascular V-Y advancement island flap

目的探讨全下唇缺损的功能性修复方法并观察其临床效果。方法6例下唇癌患者行外科手术治疗，术后下唇缺损4／5至全下唇缺损，设计以双侧颏神经血管束为蒂的颏部岛状组织瓣V—Y推进修复下唇全厚缺损，重建口轮匝肌。结果术后组织瓣全部成活，随访3～14个月，肿瘤均无复发，唇外观良好，张口度接近正常，同时保留了良好的口周括约肌功能和口唇黏膜的正常感觉功能。结论对于局限于唇红或唇红缘下方1cm内的全下唇缺损，双侧颏神经血管束为蒂的颏部岛状组织瓣V-Y推进修复方法是比较理想的功能性重建方法。

Objective To introduce a method of functional reconstruction for total lower lip defects. Methods Six patients with lower lip cancer were treated by surgery from November 2007 to February 2009. The full thickness defects with a size from eighty percent to total lower lip were reconstructed with two triangular mental neurovaseular island flaps of chin. The museulocutaneous and mucous flaps with neurovascular pedicles were advanced in a V-Y manner to close the defect and reconstruct the orbicularis oris muscle. Results All flaps survived and no recurrence and complication were observed and showed excellent cosmetic and functional results over 6 months of follow-up. The reconstructed lower lips provided a wideenough mouth opening, and the sensation of oral mucosa and the muscle function of oral sphincter were preserved. Conclusions The technique of mental neurovascular V-Y advancement island flap can get satisfactory results in both functional and the aesthetic perspects.