摘要
目的:介绍一种新颖的颈阔肌肌皮瓣术式,评价其修复口腔颌面部缺损的应用价值。方法:用围裙式颈阔肌肌皮瓣修复口腔颌面部病变切除术后缺损的患者15例。设计U形的围裙式切口制备皮瓣,保留蒂部皮肤,加宽肌蒂宽度。结果:15例围裙式颈阔肌肌皮瓣12例完全成活,3例皮瓣部分坏死。其中,修复颊黏膜、舌、牙槽突缺损的皮瓣完全成活率分别为8/9、1/3、3/3。另有2例颈部供区伤口愈合不良。所有病例经4~33个月随访,1例牙龈癌颈部瘢痕较为明显,1例舌癌舌运动受限,其余病例口腔颌面部形态、功能恢复良好。结论:和颈阔肌肌皮瓣比较,围裙式颈阔肌肌皮瓣可提供更宽的皮岛,特别适合中小型颊部软组织及牙槽突缺损的修复,舌部缺损不是该皮瓣最佳适应证。
Objective: To introduce a new style of platysma myocntaneous flap and to evaluate its application value in the restoration of oral-maxiofacial defects. Methods: Platysma myocutaneous flap with apron incision was used for the restoration of oral-maxiofacial defects after oral lesion ablation in 15 cases from January, 2014 to September, 2015. The platysma muocutaneous flap was harvested with a U shaped apron incision. The skin above the flap pedicle was preserved. The platysma pedicle was widened to ensure the flap survival. All the patients were followed up form 4 to 33 months. Results: Of the 15 platysma myecutaneous flaps,12 survived com- pletely and 3 had partial flap necrosis. The total survival rate of the flaps at the recipient site of buceal mucosa, tongue and alveolar was 8/9, 1/3 and 3/3 respectively. Additionally,there were 2 cases of disturbed wound healing in the neck. Except for 1 case of carcinoma of gingiva which had apparent cervical scar and 1 case of tongue carcinoma which had limited tongue mobility, the other cases showed a satisfactory recovery of oral-maxillofacial contour and fucnction. Conclusion: Compared with the traditional platysma myocutaneous flap, the platysma myocutaneous flap with apron incision can provide a larger skin paddle, and is suitable for the restoration of small and medium sized huccal mucosa and alveloar defects,but not for tongue defect.
作者
黄龙
郭峰
陈新群
蒋灿华
翦新春
HUANG Long GUO Feng CHEN Xinqun JIANG Canhua JIAN Xinchun.(410008 Changsha, Centre of Stomatology, Xiang Ya Hospital, Central South University, China)
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2017年第1期45-48,共4页
Journal of Practical Stomatology
基金
国家自然科学基金面上项目(编号:81041052
30572044)
关键词
围裙式切口
颈阔肌肌皮瓣
口腔颌面部
缺损
修复
Apron incision
Platysma myocutaneous flap
Oral and maxillofacial region
Defect
Restoration