股前外侧皮瓣携带肌瓣和/或脂肪瓣在口腔颌面部缺损重建中的应用

Application of Free Anterolateral Thigh Myocutaneous Flaps in Reconstruction of Oral and Maxillofacial Defects

目的:探讨股前外侧皮瓣携带肌瓣和/或脂肪瓣在口腔颌面部缺损重建中的应用。方法:收集自2014年1月—2018年12月,连云港市第一人民医院口腔科应用股前外侧皮瓣携带肌瓣和/或脂肪瓣修复口腔颌面部肿瘤切除术后的复杂缺损20例,记录皮瓣的类型与面积,供区、受区并发症,患者术后生存质量等情况。结果:所有皮瓣均存活,术后未发生血管危象。术后1例颊癌患者因涎瘘出现伤口积液,另1例出现口底瘘,换药后伤口均愈合。供区伤口仅留下线性瘢痕,术后1例出现伤口积液,经换药后伤口愈合,无感染、血肿等并发症出现。随访3~24个月,患者对面部外形及功能恢复满意。结论:股前外侧皮瓣及其嵌合皮瓣可用于填塞口腔颌面部肿瘤切除术后留下的各种死腔,覆盖钛板及颈部大血管等,能有效地预防和减少术后并发症的发生。

Objective:To explore the application of anterolateral thigh myocutaneous flaps in the reconstruction of oral and maxillofacial defects.Methods:Retrospective review of twenty consecutive patients who underwent anterolateral thigh myocutaneous flap grafts for reconstruction of oral and maxillofacial defects after tumor resection surgery from January 2014 to December 2018,in the Department of Stomatology of The First People′s Hospital of Lianyungang.Flap size and type,complications of donor site and recipient,and postoperative quality of life of patients were recorded.Results:All flaps survived and no vascular crisis occurred.One patient with buccal cancer developed wound effusion due to salivary fistula,and another patient complicated with mouth floor fistula.The wounds healed after dressing.The wound in the donor area only left a linear scar.In one case,wound effusion appeared without complications like infection or hematoma.After the dressing change,the wound healed.After 3-24 months of follow-up,patients were satisfied with facial shape and function recovery.Conclusion:The anterolateral thigh flap and its chimeric flap can be used for filling various dead spaces left after the resection of the oral and maxillofacial tumors,covering the titanium plate and the large vessels of the neck,etc.Its can effectively prevent and reduce the occurrence of surgical complications.