上斜方肌肌皮瓣在舌鳞癌术后缺损即刻修复的临床应用

Clinical application of superior trapezius myocutaneous flap for immediate restoration of tongue defect after the operation of tongue squamous cell carcinoma

目的探讨以颈横动脉为蒂的上斜方肌肌皮瓣修复舌鳞癌术后缺损的临床应用效果。方法2013年1月至2015年12月对16例经病理确诊的舌鳞癌患者均行舌颈联合根治性颈清术,术中采用以颈横动脉为蒂的上斜方肌肌皮瓣同期修复舌缺损。供区创面直接拉拢缝合,未行植皮。结果 16例患者皮瓣全部成活,皮瓣成活率为100%。术后早期再造舌外形和功能较差。术后3个月至1年,皮瓣出现黏膜化,患者的语言、咀嚼和吞咽功能改善明显。结论以颈横动脉为蒂的上斜方肌肌皮瓣是修复舌鳞癌术后缺损理想的皮瓣之一。

Objective To evaluate the clinical effect of superior trapezius myocutaneous（STM）flap with the transverse cervical artery（TCA）in reconstruction of tongue defects immediately after the neck dissection of tongue squamous cell carcinoma.Methods From January 2013 to December 2015,the combined radical neck dissection was carried out in 16 patients of tongue squamous cell carcinoma in our institute.All tongue defects were reconstructed by the STM with the TCA.The donor sites were closed directly without skin grafting.Results All flaps survived,and the success rate was 100%.Primarily,the morphology and function of the reconstructed tongues were dissatisfactory.Three months to one year after operation,the mucosalization of flaps appeared,and the functions of speech,mastication and swallowing improved obviously.Conclusion The STM with TCA is one of the ideal flap for reconstructing the postoperative defects of tongue squamous cell carcinoma.