口底癌术后组织缺损修复重建51例临床分析

Clinical analysis of reconstruction of postoperative mouth floor defect

目的评价口底癌术后缺损皮瓣修复的特点及临床效果。方法收集2006年1月至2009年12月第四军医大学口腔医院颌面外科收治的口底癌手术同期皮瓣修复缺损患者51例,观察评价皮瓣修复效果。结果术后近期,4例组织瓣坏死,28例出现不同程度并发症。术后6～24个月复查,大多患者口底伤口恢复良好,吞咽、进食无明显障碍。结论胸大肌肌皮瓣、前臂皮瓣、颈阔肌肌皮瓣和股前外侧肌皮瓣4种皮瓣能基本满足口底癌术后组织缺损修复重建需要,其中胸大肌肌皮瓣仍作为口底较大缺损者修复首选。

Objective To evaluate the effectiveness and features of different flap on repairing postoperative defect of mouth floor. Methods A retrospective review of 51 cases of mouth floor defects restored with different flap was made. The reconstruction effects of the defect region were evaluated after 6-24monthes＇ follow-up. Results Of the 51 cases, all necrosis occurred in 4 （4/51,7.8%）, and different degrees of postoperative complication occurred in 28 （28/51, 54.9%）. All patients regained near-normal appearance and oral function. Conclusion The pectoralis major myocutaneous flap, the forearm flap, platysma myocutaneous flap and anterolateral thigh flap are suitable for reconstruction of mouth floor defects, and the pectoralis major myocutaneous flap is the main management for reconstruction of mouth floor defect.