口轮匝肌为蒂肌黏膜瓣在唇癌切除术后缺损修复中的应用

Application of Musculomucosal Flap with a Pedicle of Mouth Orbicular Muscle in the Defect Repair after Lip Cancer Resection

目的探讨口轮匝肌为蒂肌黏膜瓣在唇癌切除术后创面修复中的应用。方法切除肿物,根据缺损的大小逆行设计蒂在同侧的口轮匝肌黏膜瓣180°旋转修复创面缺损。结果唇部肿物扩大切除术后,黏膜缺损最大面积约4.0cm×1.0cm,设计口轮匝肌为蒂肌黏膜瓣修复缺损,肌黏膜瓣全部存活,随访3~12个月,肌黏膜瓣存活良好,与邻近唇黏膜无明显色差,且无明显并发症。结论肿瘤切除致唇部组织缺损达到1/3~1/2唇黏膜时,与Abbe瓣相比,以口轮匝肌为蒂肌黏膜瓣修复唇部缺损,术后不需二期断蒂,供区切口隐蔽,术后功能及外观满意,是唇缺损修复的一种新方法,值得临床应用。

Objective To investigate the application of musculomucosal flap with a pedicle of mouth orbicular muscle in the defect repair after lip cancer resection. Methods After the tumors were resected, we designed the musculomucosal flap with a pedicle in the same side using the orbicular muscle of mouth according to the tissue sizes. Then the flap was rotated 180 degree to repair the defects.Results After extended resection of the lip tumors, the maximum area of lip mucosa defects was about 4.0 cm ×1.0 cm. All the musculomucosal flaps derived from mouth orbicular muscles survived after 3 to 12 months of follow-up. These flaps repaired the defects successfully, leaving no obvious color deviation from the nearby tissues. Moreover, there were no significant complications observed during follow-up. Conclusion If the lip tissue defects after tumor resection cover one-third to two-third of lip mucosa, the muscle flaps of the orbicular muscle of mouth can repair them successfully. Compared with Abbe flap, the second-stage operation of skin flap pedicle division is not needed. This novel method for lip defect repairing deserves to be used widely because of hidden donor sites, excellent postoperative function, and satisfactory appearance.