个性化前臂皮瓣在口腔颌面部缺损修复的临床观察

Clinical observation of individualized forearm flap in reconstruction of oral and maxillofaeial defects

目的探讨个性化设计的前臂皮瓣在颌面部缺损修复的方法及疗效。方法2011年3月-2015年9月收治的口腔颌面部肿瘤及面部组织缺损患者16例，男8例，女8例。年龄41-70岁，平均54岁。根据每个患者肿瘤切除后缺损的形状、大小，设计出不同形状的前臂皮瓣进行修复，术后观察移植前臂皮瓣成活情况、患者的面部外形恢复情况及语言、进食等功能恢复情况。结果术后本组患者面颈部及前臂处切口均Ⅰ期愈合，16例移植前臂皮瓣均成活。所有患者均获随访，随访时间8-36个月。肿瘤无复发，患者语言、进食、咀嚼等功能均基本正常，面部外形基本对称，患者对自己术后外形及功能恢复均较满意。结论根据颌面部的软组织缺损采取个性化的方式进行前臂皮瓣设计，能够最大程度的恢复患者的面部外形及功能，提高患者术后的生存质量，可以获得满意的修复效果。

Objective To investigate the forearm flap personalized design method and the curative effect in repairing maxillofacial defects. Methods From March, 2011 to September, 2015 , 16 cases with oral maxillofacial tumor and facial tissue defect were treated. There were 8 males and 8 females with an age range of 41-70 years （mean, 54 years）. According to the shape and size of the defect after tumor resection in each patient, the forearm flap was de- signed to repair the defect. The effectiveness was evaluated after operation by observing the survival of the forearm flap transplantation, the patient＇ s facial appearance, the functions of speech, swallowing. Results The incision healed by first intention in this group, 16 cases of forearm flap survived. All cases were followed-up 8-36 months without tumor recurrence. The functions of speech, swallowing were basically normal. The facial appearance was satisfactory. The pa- tients were satisfied with their appearance and functional recovery after operation. Conclusion Take personal way of forearm flap design according to maxillofacial soft tissue defect, can restore the maximum facial appearance and function of patients, improve the quality of life of patients after surgery to repair, can obtain satisfactory results.