鼻唇沟皮瓣修复口腔颌面部软组织缺损的临床研究

Repair of Soft Tissue Defects in Oromaxillo-facial Region with Nasolabial Flaps

目的:探讨鼻唇沟皮瓣在口腔颌面部软组织缺损修复重建中的应用价值。方法:查阅2004年1月～2009年10月因肿瘤于四川大学华西口腔医院行手术治疗并使用过鼻唇沟皮瓣进行修复的病历40例,其中男性27例,女性13例。年龄33～76岁,平均年龄59.2岁。良性肿瘤2例,恶性肿瘤38例。记录患者姓名、性别、年龄、诊断、术中情况(包括皮瓣设计、大小、手术时间、失血量)、术后成活情况及血管活性药物使用情况等。对患者进行随访,复查记录患者目前情况。统计分析鼻唇沟皮瓣在修复口腔颌面部软组织缺损中的应用价值及作用。结果:40例患者中39例一期愈合,1例二期愈合。随访发现36名患者肿瘤未见复发,皮瓣生存良好,色泽与周围组织基本一致或接近,外观形态满意,无面瘫、鼻通气功能及咀嚼功能障碍。结论:鼻唇沟皮瓣修复口腔颌面部小范围软组织缺损疗效优良,美观,特别适合皮肤松弛的中老年患者,值得推广。另外,在鼻唇沟皮瓣修复口腔颌面部软组织缺损术后,不必应用血管活性药物。

Objective： To discuss the application value of nasolabial flap in the reconstruction of soft tissue defects in the oral and maxillo-facial region. Methods： We did a retrospective research to study the prosthetic effect of na- solabial flap which includes 40 case from January 2004 to October 2009. All of those patients were received opera- tion in West China Hospital of Stomatology because of tumor, and the ratio between male and female was 27： 13. The max age was 76 while the min age was 33, the median was 59.2. 2 cases of benign tumor and 38 cases of ma- lignance tumor were included in this research. The information about patients were recorded which compose of name, sex, age, diagnosis, intraoperative conditions including the design and size of flap, the time of operation and the loss of blood, the postoperative suvive conditions of flap and the application of vasoactive drugs. Through follow -up, recording the present situation of flap. Finally, we evaluated the application value and function of Nasolabial flap in the reconstruction of soft tissue defects in the oromaxillo-facial region. Results： There were 39 case of pri- mary healing and one case of secondary healing among 40 cases. During later follow-up, no tumor recurrence were noted in 36 cases and the survive condition of flap was good, so was the colour and the shape. No facial paralysis, disfunction of nose venting and chewing. Conclusion： Nasolabial flap is an effective method to reconstruct small scale soft tissue defects in the oromaxillo-facial region. The prosthetic effect of nasolabial flap fits for the standards of beauty and especially situ for those old patients. Moreover, postoperation using vasoactive drugs is not necessary for the survival of this flap.