锁骨上岛状皮瓣修复头颈肿瘤手术缺损临床初步研究

Clinical experience with the supraclavicular flap to reconstruct head and neck defects

目的研究锁骨上岛状皮瓣修复头颈部术后缺损的临床应用。方法回顾性分析2013年5月至2014年12月，中国医学科学院北京协和医学院肿瘤医院头颈外科应用带蒂锁骨上岛状皮瓣修复头颈部肿瘤手术缺损10例患者的病历资料，其中下咽癌缺损修复6例，舌癌修复2例，口底癌1例，颈段食管癌1例。皮瓣面积（5-8）cm×（6-12）cm。结果7例皮瓣全部存活，1例全部坏死，2例部分坏死，其他并发症包括咽瘘和伤口感染各l例。供区缺损均直接拉拢关闭。结论锁骨上岛状皮瓣修复头颈部缺损比较可靠，制取技术简单，不需要显微外科技术，适合广大基层的耳鼻咽喉头颈外科和口腔科医生应用。

Objective To evaluate the efficacy of pedicled supraclavicular artery island flaps for head and neck reconstruction. Methods Reconstructive surgeries for head and neck oncologic defects were performed with the pedicled supraclavicular artery island flaps in 10 patients from May 2013 to December 2014 and the cases were review. Among them, 6 were performed for hypopharyngeal cancer, 2 for oral tongue cancer, 1 for oral base cancer and I for cervical esophageal cancer. The size of the flaps was measured in （5 - 8） cm Х （6 - 12） cm. Results Seven flaps survived, one flap failured and two flaps had partial necrosis. Donor sites were closed primarily without morbidity. Conclusion The pedicled supraclavicular artery island flap is an easy harvesting and reliable for head and neck reconstruction, esoeciallv suitable for otolarvngo-head and neck surgeon and maxillofacial surgeon in the local hospital.