Yu瓣和Karapandzic瓣修复下唇2/3以上缺损的临床效果比较

Comparison of clinical effects of the Yu flap and the Karapandzic flap in repairing greater than 2/3 lower lip defects

目的对比Yu瓣和Karapandzic瓣修复下唇2/3以上缺损的临床效果,为临床应用提供参考。方法下唇肿瘤与血管畸形手术切除后下唇缺损达2/3以上患者10例,5例采用Yu瓣修复(Yu瓣组),5例采用Karapandzic瓣修复(Karapandzic瓣组),术后随访至少1年,对重建的下唇进行形态评价(口角对称、小口畸形、唇红暴露)和功能评价(唇部感觉功能、唇部运动功能)。结果所有患者皮瓣均存活,伤口均获得一期愈合,采用Yu瓣或Karapandzic瓣重建的下唇获得相似的令人满意的口腔功能:感觉功能基本恢复,言语、表情无明显障碍,无口水外漏现象发生;Yu瓣组1例出现轻微小口畸形,Karapandzic瓣组2例有轻微小口畸形,3例有中度小口畸形;90%(9/10)患者对术后效果非常满意,Karapandzic瓣组1例基本满意。结论 Yu瓣和Kara-pandzic瓣均可用于修复下唇2/3以上缺损,效果可靠,这两种方法可以取得相似的术后口腔功能,但在美观方面Karapandzic瓣逊色于Yu瓣,常有小口畸形情况发生,而使用Yu瓣修复一般可保持原有口裂的大小。

Objective To compare the clinical effect of the Yu flap and the Karapandzic flap in repairing greater than 2/3 defects of the lower lip and to provide a reference for clinical application.MethodsTen patients with greater than 2/3 lower lip defects after surgical resection of lower lip tumors and vascular malformations were enrolled:5 patients were repaired with the Yu flap(Yu flap group)and 5 patients were repaired with the Karapandzic flap(Karapandzic flap group).Follow-up for at least 1 year was conducted to evaluate the morphology(symmetry,stoma,exposure of vermilion)and function(sensory function,motor function)of the reconstructed lower lip.ResultsAll the flaps survived,and all wounds showed primary healing.The lower lips reconstructed with the Yu flap or the Karapandzic flap obtained similar satisfactory oral function.The sensory function was essentially restored.There were no obvious obstacles in speech and expression,and no saliva leakage occurred.In the Yu flap group,only 1 patient had slight microstomia.In the Karapandzic flap group,2 patients had slight microstomia and 3 patients had moderate microstomia.90%(9/10)of the patients were very satisfied with the postoperative outcome,and 1 patient in the Karapandzic flap group was basically satisfied.Conclusion Both the Yu flap and the Karapandzic flap can be used to repair greater than 2/3 lower lip defects and reliable outcomes can be achieved.These two methods can achieve similar oral functions,but the effect of the Karapandzic flap is inferior to that of the Yu flap in terms of aesthetic appearance,and microstomia often occurs,while the Yu flap can generally maintain the original size of the mouth cleft.