比目鱼肌肌皮穿支小腿外侧皮瓣在口腔颌面部缺损修复中的应用

Application of soleus perforator flapfrom the lateral leg in repair of oral and maxil-lofacial defects

目的口腔颌面部恶性肿瘤术后常出现口腔颌面部软组织大面积缺损,需进行口腔颌面部缺损修复以最大程度恢复患者外观及口腔功能。文中探讨比目鱼肌肌皮穿支小腿外侧皮瓣在口腔颌面部缺损修复中的应用方法及价值。方法回顾性分析阜阳市人民医院口腔颌面外科2015年5月至2019年3月期间收治的口腔颌面部恶性肿瘤患者10例患者研究资料。分析比目鱼肌肌皮穿支小腿外侧皮瓣应用效果,随访记录术后1、3个月口腔功能恢复情况、供区恢复情况、生活质量及手术满意度。结果10例患者手术顺利,无一例皮瓣坏死或严重并发症发生;术后3个月所有患者语音功能和吞咽功能均达到3级,瘢痕增生、供区瘙痒各1例,无感觉异常及功能障碍病例;与术后1个月比较,术后3个月华盛顿大学头颈肿瘤生活质量量表中社会功能评分[(65.48±4.37)vs(78.64±4.78)]及身体功能评分[(43.80±3.04)vs(53.75±2.66)]均显著升高,差异有统计学意义(P<0.05)。结论比目鱼肌肌皮穿支小腿外侧皮瓣是修复口腔颌面部缺损的理想游离皮瓣。术后口腔功能、供区恢复良好,生活质量及手术满意度较高。

Objective Reconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient’s appearance and oral function.The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.Methods In this retrospective study,ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People’s Hospital during the period from May 2015 to March 2019 were enrolled.The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery,the recovery of oral function and donor sites,quality of life and surgical satisfaction were followed.Results Allpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3.The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery,the scores at 3 months after surgery were increased using the University of Washington Quality of Life(UW-QOL)questionnaire(P<0.05).At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00%and 90.00%,respectively.Conclusion The soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects.The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.