游离股前外侧皮瓣重建口颊癌术后口内外大面积联合缺损的临床效果

Technique and effect of free anterolateral thigh flap in reconstruction of large through-and-through defects after tumor resection

目的:探讨游离股前外侧皮瓣(肌皮瓣)在修复口颊部联合大型洞穿性缺损中的重建方法和效果。方法:选取2015年10月～2018年10月收治的颊癌患者37例,回顾性分析颊颌颈联合根治术后,口内外大型缺损应用股前外侧皮瓣修复的临床资料。结果:37例患者术后洞穿缺损全部应用游离股前外侧皮瓣修复,皮岛共58块,双叶皮瓣21例,带肌岛29例。皮瓣危像探查2例,均成活。术后随访3～44个月,平均23个月,患者术后开口、外形、语言、吞咽、咀嚼功能均获得一定恢复。供区和受区无明显严重并发症。结论:股前外侧皮瓣是修复口腔颌面部大面积缺损的主要手段,其组织结构的丰富性赋予了设计的多样性、灵活性,修复效果满意。

Objective:To explore the reconstruction method of extensive through-and-through cheek defects and evaluate the efficacy.Methods:Thirty-seven cases were collected and the clinical data of whom underwent reconstruction of through-and-through cheek defects with anterolateral thigh flap were retrospected.Results:All of the patients with throughand-through cheek defects were constructed with anterolateral thigh flap.Among 37 case,that were 58 skin flap,21 of bilobate flap,29 cases with separate muscle island were performed.The mean follow-up period was 23 months(3~44 months).The mouth-opening,appearance,speech,chewing,swallowing,and other oral functions were well recovered.Conclusion:Anterolateral thigh flap is a workhorse flap for the reconstruction of through-and-through oral and maxillofacial defects,and the richness of the organizational structure enable the design with diversity and flexibility.